Consumer Access to Buprenorphine in Publicly Funded Specialty Treatment Programs for Opioid Use Disorder

14 Pages Posted: 27 Jul 2022

See all articles by Ned Presnall

Ned Presnall

Independent

Giulia Croce Butler

Saint Louis University

Richard Grucza

Saint Louis University - Family and Community Medicine

Date Written: June 17, 2022

Abstract

Background: Since 2017, the Substance Abuse and Mental Health Administration (SAMHSA) has invested unprecedented funding in opioid use disorder (OUD) treatment to mitigate the epidemic of opioid-related deaths. A key priority of this investment has been the expansion of buprenorphine treatment for persons with OUD.

Methods: Using a “secret shopper” method we developed for a prior study of certified community behavioral health centers, we surveyed a random sample of 520 publicly funded treatment programs listed in SAMHSA’s behavioral health treatment locator as providing maintenance buprenorphine therapy. The sample was drawn from all 50 states and 3 territories which received block grant funding for substance use disorder (SUD) treatment. By simulating the experience of a patient seeking treatment, we aimed to provide a “real-world” adjustment to agency-level data on buprenorphine availability in publicly funded treatment and, further, to characterize the treatment “threshold” patients face by estimating the number of agencies that offer buprenorphine provider visits on the day of patient intakes.

Results: Among the 520 agencies surveyed, 25.6% did not answer our two call attempts or return our messages. Another 55.4% said they provide buprenorphine maintenance, as indicated in the treatment locator. An additional 8.9% of agencies offered to provide a referral for buprenorphine treatment, and 9.8% neither offered buprenorphine therapy for OUD nor offered a referral for buprenorphine treatment. Among agencies that answered or returned our calls, 74.4% of agencies coded in SAMHSA’s treatment locator as providing buprenorphine maintenance confirmed their provision of this service and 23% indicated that patients could see a buprenorphine prescriber on their first day of treatment.

Conclusions: Buprenorphine remains difficult to access in publicly funded treatment programs for OUD. The programs which do provide buprenorphine appear largely unable to provide low-threshold access to patients seeking treatment.

Note:
Funding Information: This work was supported by the Arnold Foundation grant: “State-level Barriers and Facilitators to Evidence-Based Treatment of Opioid Use Disorder in Publicly Funded Treatment.”

Conflict of Interests: Ned J. Presnall is an owner of Plan You Recovery, LLC and CB Programs, LLC which provide addiction and mental health treatment. Richard A. Grucza is a consultant for Janssen Pharmaceutical. Giulia Croce Butler reports no conflicts of interest.

Ethical Approval: The St. Louis University Institutional Review Board did not deem this project to be human subjects research.

Keywords: block grant, buprenorphine, opioid use disorder, OUD, pharmacotherapy, State Opioid Response, SOR

Suggested Citation

Presnall, Ned and Croce Butler, Giulia and Grucza, Richard, Consumer Access to Buprenorphine in Publicly Funded Specialty Treatment Programs for Opioid Use Disorder (June 17, 2022). Available at SSRN: https://ssrn.com/abstract=4139779

Giulia Croce Butler

Saint Louis University ( email )

1402 S. Grand Blvd
St. Louis, MO 63104
United States
3144557548 (Phone)

Richard Grucza

Saint Louis University - Family and Community Medicine ( email )

1402 S. Grand Blvd
St. Louis, MO 63104
United States

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