Federal Impacts on Buprenorphine Prescribing in Washington State, 2012 to 2022

Fan Xiong, Jillian Jetson, Cheolwoo Park, Chris Delcher

Research output: Contribution to journalArticlepeer-review


Objectives. To evaluate changes in monthly buprenorphine dispensation associated with federal prescribing policies in Washington State from 2012 to 2022. Methods. We conducted an interrupted time series analysis comparing monthly buprenorphine prescriptions dispensed per 1000 population after the Comprehensive Addiction and Recovery Act (CARA), Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT), and new prescribing rules during the COVID-19 pandemic. Buprenorphine formulated for opioid use disorder was included from the Washington State Prescription Monitoring Program. A log-linear autoregressive model measured linear trend changes. Results. Physician prescribing increased by 1.63% (95% confidence interval [CI] 5 1.41%, 1.85%) per month after CARA with sustained declines after SUPPORT. Nurse practitioner (NP) prescribing increased by 19.48% (95% CI 5 18.8%, 20.16%) per month after CARA with physician assistants (PAs) showing similar trends. Following the implementation of SUPPORT, NP and PA trends continued to increase at a reduced growth rate of 3.96% (95% CI 5 2.01%, 5.94%) and 1.87% (95% CI 5 0.56%, 3.19%), respectively. No prescribers experienced increases during the COVID-19 pandemic. Conclusions. CARA nearly tripled the buprenorphine prescribing rate. The SUPPORT Act initiated sustained declines for physician prescribing, and the COVID-19 period reversed gains for PAs and NPs. The current opioid crisis requires expanded efforts in Washington State. (Am J Public Health.

Original languageEnglish
Pages (from-to)696-704
Number of pages9
JournalAmerican Journal of Public Health
Issue number7
StatePublished - Jul 2024

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© 2024 American Public Health Association Inc.. All rights reserved.

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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