Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic

Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times

“…In recognition of pandemic conditions, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued regulatory changes in March 2020 around the delivery of MOUD, including increases in the number of take-home doses allowed as well as lifting administrative limits placed on the number of new patients for whom providers can issue prescriptions [ 35 ]. The effect of these policy changes can be seen in Amram et al’s [ 36 ] findings of increased average take-home dose per client during the pandemic in Spokane, WA, and Jones et al’s [ 37 ] finding that a third of clinicians from an email survey reported prescribing to new patients during the pandemic without in-person examination. Caton et al [ 38 ] also found that 65% of the 57 MOUD primary care clinics in their study reported longer buprenorphine prescribing periods, whereas Brothers et al [ 39 ] found increases between 19% to 16,700% in the proportion of Connecticut patients receiving 3 to 28-day take home dose supplies during the pandemic compared to before.…”

“…Although evidence on changes in health services access for those with illicit substance use are more robust compared with the previous domains, the outcomes reported are, once again, varied and fragmented across different study settings. In general, the reduction of limits on MOUD prescribing practices by SAMHSA gave rise to enhanced and lower-barrier access primarily within individual MOUD clinics in terms of buprenorphine initiation, prescription, and dosage duration [ 31 , 36 , 37 , 38 , 39 , 40 ]. Broader state and nationwide data relating to other aspects of the treatment cascade, including referrals, prescription fillings, and general program capacities, indicate that the regulatory changes were not sufficient to mitigate disruptions of service access relating to the pandemic [ 41 , 42 , 43 , 44 ].…”

Adaptations to Opioid Use Disorder Care During the COVID-19 Pandemic: A National Survey of Prescribers

“… 18 The percentages of prescribers using virtual visits to provide OUD care for existing patients and to initiate buprenorphine in new patients were higher in our study; this may be related to the higher percentage of addiction certified providers in our sample who may feel more comfortable providing virtual care and our exclusion of emergency medicine physicians who were unlikely to provide virtual care. 19 …”

Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic

“…Studies have documented initial findings related to how health systems, 19 , 20 , 21 OTPs, 22 , 23 , 24 and office-based treatment providers 25 , 26 , 27 have leveraged these new authorities to modify service delivery during the COVID-19 pandemic. While these studies provide important insights, they largely focus on single health systems or jurisdictions (ie, state or city), how clinicians have modified their practices, or have only examined the initial months of the COVID-19 pandemic.…”