Legal and policy changes urgently needed to increase access to opioid agonist therapy in the United States

Davis, Corey S.; Carr, Derek

doi:10.1016/j.drugpo.2019.07.006

Cited by 34 publications

(30 citation statements)

References 44 publications

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“…The response to the US opioid overdose crisis urgently requires the implementation of evidence-based primary, secondary, and tertiary prevention. The policy changes that are needed to support these interventions are well understood and have been discussed extensively [80,[176][177][178]]. Yet the stigma attached to OUDs remains a fundamental hindrance to the crisis response.…”

Section: Addressing Stigma To Support the Us Opioid Overdose Crisis Rmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

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• The current United States opioid overdose crisis is a complex, multifaceted, public health emergency that urgently requires the implementation of evidence-based primary, secondary, and tertiary preventive interventions. We develop a typology of the stigma related to opioid use, showing how multiple dimensions of stigma continue to fundamentally hinder the response to the crisis. • Public stigma is driven by stereotypes about people with opioid use disorders, such as their perceived dangerousness or perceived moral failings, which translate into negative attitudes toward people with opioid use disorders. • Enacted stigma describes the behavioral manifestations of public stigma, including discrimination and social distancing. Public and enacted stigma, in turn, lead to delivery of suboptimal care and undermine access to treatment and harm reduction services. • Public stigma and enacted stigma can become structural stigma when they become encoded in cultural norms, laws, and institutional policies. Collectively, these forms of stigma run at cross purposes to-and reduce public support for-public health-oriented policies to address the opioid overdose crisis.

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Section: Addressing Stigma To Support the Us Opioid Overdose Crisis Rmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

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“…( Olfson, Zhang, Schoenbaum, & King, 2020 ) Federal laws that make buprenorphine for OUD difficult to access for many patients, including those most at-risk for overdose death, are a key driver of the persistent gap between treatment need and availability. ( Davis & Carr, 2019 )…”

Section: Buprenorphine For Opioid Use Disordermentioning

confidence: 99%

“…( Davis, 2019 ) However, buprenorphine for OUD remains more difficult to access than nearly all other medications, including opioid analgesics, illicit opioids, and buprenorphine when prescribed for pain. ( Davis & Carr, 2019 )…”

Section: Permanently Reducing Barriers To Buprenorphinementioning

confidence: 99%

Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19

Davis

Samuels

2021

International Journal of Drug Policy

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“…The objectives of this report were to extend upon existing knowledge regarding access to buprenorphine 3,4,17,[20][21][22][23][24][25][26] and to describe the temporal and regional changes in US buprenorphine utilization over the last decade. were negligible in all study years).…”

Section: Key Pointsmentioning

confidence: 99%

Rise and regional disparities in buprenorphine utilization in the United States

Azar

Cruz-Mullane

Podd

et al. 2020

Pharmacoepidemiology and Drug

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Purpose Buprenorphine is an opioid partial agonist used to treat opioid use disorder. While several policy changes have attempted to increase buprenorphine availability, access remains well below optimal levels. This study characterized how buprenorphine utilization in the United States has changed over time and whether there are regional disparities in distribution of the medication. Methods The amount of buprenorphine distributed from 2007 to 2017 was obtained from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System. Data were expressed as the percent change and milligrams per person in each state. The formulations and cost for prescriptions covered by Medicaid (2008 to 2018) were also examined. Results Buprenorphine distributed to pharmacies increased about 7‐fold (476.8 to 3179.9 kg) while the quantities distributed to hospitals grew 5‐fold (18.6 to 97.6 kg) nationally from 2007 to 2017. Buprenorphine distribution per person was almost 20‐fold higher in Vermont (40.4 mg/person) relative to South Dakota (2.1 mg/person). There was a strong association between the number of physicians authorized to prescribe buprenorphine and distribution per state (r[49] = +0.94, P < .0005). The buprenorphine/naloxone sublingual film (Suboxone) was the predominant formulation (92.6% of 0.31 million Medicaid prescriptions) in 2008 but accounted for less than three‐fifth (57.3% of 6.56 million prescriptions) in 2018. Conclusions Although buprenorphine availability has substantially increased over the last decade, distribution was very nonhomogeneous across the United States.

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Legal and policy changes urgently needed to increase access to opioid agonist therapy in the United States

Cited by 34 publications

References 44 publications

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19

Rise and regional disparities in buprenorphine utilization in the United States

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