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Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes

BACKGROUND: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use disorder (MOUD; e.g., buprenorphine) are effectiv...

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Autores principales: Hirchak, Katherine A., Amiri, Solmaz, Kordas, Gordon, Oluwoye, Oladunni, Lyons, Abram J., Bajet, Kelsey, Hahn, Judith A., McDonell, Michael G., Campbell, Aimee N. C., Venner, Kamilla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131568/
https://www.ncbi.nlm.nih.gov/pubmed/35614487
http://dx.doi.org/10.1186/s13011-022-00457-3
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author Hirchak, Katherine A.
Amiri, Solmaz
Kordas, Gordon
Oluwoye, Oladunni
Lyons, Abram J.
Bajet, Kelsey
Hahn, Judith A.
McDonell, Michael G.
Campbell, Aimee N. C.
Venner, Kamilla
author_facet Hirchak, Katherine A.
Amiri, Solmaz
Kordas, Gordon
Oluwoye, Oladunni
Lyons, Abram J.
Bajet, Kelsey
Hahn, Judith A.
McDonell, Michael G.
Campbell, Aimee N. C.
Venner, Kamilla
author_sort Hirchak, Katherine A.
collection PubMed
description BACKGROUND: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use disorder (MOUD; e.g., buprenorphine) are effective, evidence-based treatments that can be delivered in office-based primary care settings. We investigated disparities in the proportion of national prescribers who have obtained a waiver issued to prescribe MOUD by demographic characteristics. METHODS: Data for the secondary data analyses were obtained from the Drug Enforcement Administration that maintains data on waivered MOUD prescribers across the US. Proportion of waivered prescribers were examined by ZIP code, race and ethnicity composition, socioeconomic status, insurance, and urban–rural designation using generalized linear mixed effects models. RESULTS: Compared with predominantly Non-Hispanic White ZIP codes, other racially and ethnically diverse areas had a higher proportion of waivered buprenorphine prescribers. Differences in prescriber availability between predominant racial group was dependent on rurality based on the interaction found in our fitted model. In metropolitan areas, we found that predominantly Non-Hispanic White ZIP codes had a lower rate of waivered prescribers compared to predominantly Black/African American ZIP codes. CONCLUSIONS: Our findings suggest that among AI/AN and Black/African American neighborhoods, availability of waivered prescribers may not be a primary barrier. However, availability of waivered prescribers and prescribing might potentially be an obstacle for Hispanic/Latinx and rural communities. Additional research to determine factors related to improving MOUD availability among diverse communities therefore remains vital to advancing health equity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-022-00457-3.
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spelling pubmed-91315682022-05-26 Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes Hirchak, Katherine A. Amiri, Solmaz Kordas, Gordon Oluwoye, Oladunni Lyons, Abram J. Bajet, Kelsey Hahn, Judith A. McDonell, Michael G. Campbell, Aimee N. C. Venner, Kamilla Subst Abuse Treat Prev Policy Research BACKGROUND: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use disorder (MOUD; e.g., buprenorphine) are effective, evidence-based treatments that can be delivered in office-based primary care settings. We investigated disparities in the proportion of national prescribers who have obtained a waiver issued to prescribe MOUD by demographic characteristics. METHODS: Data for the secondary data analyses were obtained from the Drug Enforcement Administration that maintains data on waivered MOUD prescribers across the US. Proportion of waivered prescribers were examined by ZIP code, race and ethnicity composition, socioeconomic status, insurance, and urban–rural designation using generalized linear mixed effects models. RESULTS: Compared with predominantly Non-Hispanic White ZIP codes, other racially and ethnically diverse areas had a higher proportion of waivered buprenorphine prescribers. Differences in prescriber availability between predominant racial group was dependent on rurality based on the interaction found in our fitted model. In metropolitan areas, we found that predominantly Non-Hispanic White ZIP codes had a lower rate of waivered prescribers compared to predominantly Black/African American ZIP codes. CONCLUSIONS: Our findings suggest that among AI/AN and Black/African American neighborhoods, availability of waivered prescribers may not be a primary barrier. However, availability of waivered prescribers and prescribing might potentially be an obstacle for Hispanic/Latinx and rural communities. Additional research to determine factors related to improving MOUD availability among diverse communities therefore remains vital to advancing health equity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-022-00457-3. BioMed Central 2022-05-25 /pmc/articles/PMC9131568/ /pubmed/35614487 http://dx.doi.org/10.1186/s13011-022-00457-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hirchak, Katherine A.
Amiri, Solmaz
Kordas, Gordon
Oluwoye, Oladunni
Lyons, Abram J.
Bajet, Kelsey
Hahn, Judith A.
McDonell, Michael G.
Campbell, Aimee N. C.
Venner, Kamilla
Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title_full Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title_fullStr Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title_full_unstemmed Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title_short Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
title_sort variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131568/
https://www.ncbi.nlm.nih.gov/pubmed/35614487
http://dx.doi.org/10.1186/s13011-022-00457-3
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