Many rural Americans do not have access to buprenorphine

NOTAccording to a new information leaflet on Pew, one-third of rural Americans live in a county without access to buprenorphine – the gold standard for the treatment of opioid use disorders.

In contrast, almost all (97.8%) Americans living in cities live in cities that have buprenorphine suppliers.

To legally prescribe and administer buprenorphine – a form of badisted medical treatment (ART) – clinicians must complete eight hours of mandatory training, request an online dispensation, and keep detailed records of prescribing and treatment activities.

Pew acknowledges that lack of access to buprenorphine is part of a larger problem: citizens of the country do not have sufficient access to opioid treatment programs (institutions offering MAT and drugs). Other simultaneous services such as counseling). And with the WBS too, rural areas are experiencing a special shortage, with about 88.6% of "large rural counties[ing] a sufficient number of OTP. "

This disparity has been illustrated for Filtered by Dr. Elizabeth Ryan. In September 2018, she wrote that "the disproportionate distribution of opioid use in rural areas is reflected by the alarming fact that patients from as many as 17 counties have arrived in prison. [REACH, the clinic in Ithaca, NY where she works] for MAT "within six months after opening in early 2018.

"At first, it surprised us a lot. But they arrive because there is no help where they live, "concluded Ryan.

According to a survey of physicians conducted by the Federal Office of Rural Health, the main reason given (found by 48% of respondents) for not incorporating buprenorphine into their clinical practice was "diversion or abuse". drug abuse ". "Time constraints" (40.2%) and "lack of available mental health or psychosocial support services" (44.4%) were also frequently cited in the survey.

In addition, in an interview with Filtered In December 2018, Dr Kim Sue of the Coalition for Harm Reduction acknowledged that evenphysicians who are dispensed with the prescription of buprenorphine [sometimes] finally, do not end up prescribing it. There is a lot of fear, a lot of misconceptions, and this is due to the strange regulatory system we have around. "

But the federal government and its advocates are working to bridge the gap in access to waivers. On the one hand, buprenorphine prescribers are expanding. In January 2018, the once-temporary policy of allowing medical badistants and nurse practitioners to prescribe buprenorphine after training became permanent; Clinical nurse specialists have also been added to this cohort.

As a result of this expansion and the number of physicians accessing prescription relief, the number of providers able to prescribe buprenorphine per 100,000 population has doubled in rural counties. Telemedicine is also used to connect more patients to qualified providers.

Proponents of this policy argue that health professionals should be able to prescribe a drug that reduces the potential harms of other medications that they prescribe. "If you're allowed to do one, you should be able to do the other," said Stanford psychiatrist Keith Humphreys. Pacific Standard.

Photo: Suoxual Suboxone (Buprenorphine / Naloxone 8mg / 2mg) Tablets by Jr de Barbosa, under a Creative Commons Attribution-Share Alike 3.0 License, CC BY-SA 3.0