Problem statement: Unintentional drug overdose deaths associated with prescription opioids rose 395% between 1999 and 2007, and opiate misuse among adolescents is now twice as common as in the 1990s. Because methadone maintenance clinics are largely non-existent in rural areas, an effective alternative is training physicians in the use of buprenorphine, an effective addiction treatment that can be administered in outpatient practices.

Project goals: A key aim of the Drug Addiction Treatment Act of 2000, a federal law that permits physicians to prescribe buprenorphine, is providing office-based accessible care for patients addicted to opioids in the rural US Because little is known about this workforce, our national study will cover all 20,604 physicians who had received a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine for the treatment of opioid addiction as of 2011, describing them by age, sex, specialty, rurality and practice type.

Methods: Using secondary data from the DEA and the AMA Masterfile, we will aggregate waivered physicians into urban and rural area types, and identify their practices as private, public, or part of a public safety net organization. Measures: Waivered physicians will be described by age, sex, specialty, rurality and practice type. Measures of assumed need, such as rates of opiate use in the population, and rates of opiate-associated deaths will be developed and contrasted with the availability of buprenorphine providers.

Publications

• Changes in the Supply of Physicians With a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
  Policy Brief
  WWAMI Rural Health Research Center
  Date: 05/2017
  This project mapped the location of physicians with a DEA DATA 2000 waiver to prescribe buprenorphine for opioid use disorder in July 2012 and April 2016. The number of counties without a waivered physician and the ratio of waivered physicians per 100,000 population is reported by the rural/urban status of the county.
• Geographic and Specialty Distribution of U.S. Physicians Trained to Treat Opioid Use Disorder
  Journal Article
  WWAMI Rural Health Research Center
  Date: 01/2015
  Examines the distribution of physicians authorized to treat opioid use disorder in the United States, and proposes increasing access to office-based treatment as a promising strategy to address rising rates of opioid use disorder in rural areas.