Abstract: Barriers and Opportunities for Prescribing Buprenorphine for Opioid Use Disorder (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)
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163P Barriers and Opportunities for Prescribing Buprenorphine for Opioid Use Disorder

Schedule:
Friday, January 13, 2023
Phoenix C, 3rd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Li Li, MD, PhD, Associate Professor, University of Alabama, Birmingham
Ellen Robertson, PhD, Project Director, University of Alabama, School of Social Work
Ishika Patel, Undergraduate Student, University of Alabama, Birmingham
Haelim Jeong, MSW, Doctoral student, University of Alabama, School of Social Work
David Albright, PhD, University Distinguished Research Professor & Hill Crest Foundation Endowed Chair in Mental Health Research, University of Alabama, Tuscaloosa, AL
Background and Purpose. Opioid-related overdose deaths have significantly increased in the United States and in Alabama. Despite this, medications for opioid use disorder OUD (MOUD) remains significantly underutilized and X-waivered providers do not treat the number of patients they are approved. Thus, this study aims to gain a better understanding of clinicians’ viewpoints on potential barriers and opportunities likely to impact and improve the access to MOUD.

Methods. A cross-sectional survey study was conducted with Alabama’s X-waived providers. The survey asked providers to report their viewpoints, motivations, and feelings on being X-waived certified. The results from the survey were utilized to quantify, and determine a repeated pattern, if any, in responses to understand the state of practices in Alabama on using MOUD.

Results. Among the 85 responses collected from the survey, there were 71 physicians, 11 nurse practitioners and 3 physician assistants. These individuals listed several reasons for acquiring the X-Waiver numbers. Of all respondents, approximately 80% were certified to treat more than 30 patients; however, only about 30% of those providers are treating patients over 30. Furthermore, more than 70% of the respondents reported they are confident in identifying and diagnosing OUD in the practice, recognizing opioid withdrawal signs and symptoms, prescribing buprenorphine for patients with opioid withdrawal, and instructing patients on how to take buprenorphine at home including initiation of home induction. A similar percentage of the group also reported their willingness to work with patients with OUD and conveyed they find working with OUD patients satisfying and manifest the patience required to care for them. In addition to these factors, we learned that policy change and advocacy are essential to overcoming the barriers that limit proper access to treatment for OUD.

Conclusions and Implications. Our findings suggest both positive and negative aspects to the current condition of X-waivered providers. Several barriers and opportunities are identified in our survey data which could be used to explore the MOUD expansion. Furthermore, policy changes are also indicated particularly the insurance coverage of MOUD treatment.

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