Comparing buprenorphine-prescribing physicians across nonmetropolitan and metropolitan areas in the United States

Lewei Allison Lin, Hannah K. Knudsen

Research output: Contribution to journalArticlepeer-review

14 Citations (SciVal)


PURPOSE Although there is a tremendous need to increase the use of buprenorphine for the treatment of opioid use disorder in rural areas, little is known about current rural/urban differences in treatment practices. We aimed to examine physician characteristics, treatment practices, and concordance with treatment guidelines among buprenorphine prescribers across different locations of practice. METHODS A national random sample of buprenorphine physician prescribers was surveyed (n = 1,174, response rate = 33%) from July 2014 to January 2017. Analyses examined buprenorphine treatment across locations of practice (categorized as nonmetropolitan, small metropolitan, and large metropolitan). RESULTS Among buprenorphine prescribers surveyed, 11.2% (n = 132) practiced in nonmetropolitan/rural areas, 32.5% (n = 382) in small metropolitan areas, and 56.2% (n = 660) in large metropolitan areas. Buprenorphine prescribers in nonmetropolitan areas were much more likely to be primary care physicians, accept Medicaid, and less likely to work in an individual practice. Overall, buprenorphine prescribers across the rural/urban continuum were similar in many of their treatment practices, including induction, frequency of visits, dosing, and use of psychosocial treatment, which were generally consistent with buprenorphine treatment recommendations. CONCLUSIONS There are important differences in characteristics of buprenorphine prescribers in nonmetropolitan areas compared with more urban areas, including the fact that the majority of nonmetropolitan physicians are primary care physicians. Although treatment access in rural areas is an ongoing challenge, buprenorphine treatment practices are similar. Understanding buprenorphine prescribers and their treatment practices may help inform tailored strategies to address treatment needs in different locations.

Original languageEnglish
Pages (from-to)212-220
Number of pages9
JournalAnnals of Family Medicine
Issue number3
StatePublished - May 1 2019

Bibliographical note

Funding Information:
This research was supported by a grant from the National Institute on Drug Abuse (NIDA R33DA035641), within the National Institutes of Health (NIH). Use of REDCap for data management was supported by NIH’s National Center for Advancing Translational Sciences (NCATS UL1TR000117). The authors are solely responsible for this manuscript, which does not represent the official views of NIDA, NIH, or NCATS.

Publisher Copyright:
© 2019, Annals of Family Medicine, Inc. All rights reserved.


  • Buprenorphine
  • Nonmetropolitan
  • Opioid use disorder
  • Opioid-related disorders
  • Rural
  • Rural health
  • Treatment quality

ASJC Scopus subject areas

  • Family Practice


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