An estimated 6.1 million individuals in the U.S. had opioid use disorder (OUD) in 2022. Buprenorphine is an effective medication for OUD, but access to this life-saving medication can be difficult, especially in rural areas. Despite legislative changes to expand the types of clinicians who could obtain a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine for OUD, rural communities have lagged behind their urban counterparts in access to buprenorphine treatment for the past 10 years. In 2022, almost three times the proportion of rural compared to urban counties lacked any clinician with a DEA waiver to prescribe buprenorphine.

In 2018, the Federal Office of Rural Health Policy launched the Rural Communities Opioid Response Program (RCORP) initiative to improve access to prevention, treatment, and recovery services for rural patients with opioid use disorder. A primary focus of several waves of the RCORP funding was to expand the available workforce that could provide buprenorphine treatment for OUD. The number of clinicians who held a DEA waiver to prescribe buprenorphine in rural counties increased over the first five years of the RCORP funding. These counties had on average four more waivered clinicians per 100,000 population than counties where RCORP- funded activities did not take place, suggesting evidence of program effectiveness. However, at the beginning of 2023, the requirement to hold a DEA waiver to prescribe buprenorphine for OUD was eliminated. This made tracking the workforce that prescribes buprenorphine more challenging.

This project will address this new tracking gap by measuring the number of clinicians who are actually prescribing buprenorphine and the population-adjusted number of patients receiving a prescription.