Abstract
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 language | English |
|---|---|
| Pages (from-to) | 696-704 |
| Number of pages | 9 |
| Journal | American Journal of Public Health |
| Volume | 114 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2024 |
Bibliographical note
Publisher Copyright:© 2024 American Public Health Association Inc.. All rights reserved.
Funding
This project was supported by grant 2019-PM-BX-0009 awarded by the Bureau of Justice Assistance. The Washington State Department of Health supported this analysis. C. Park\u2019s work was supported in part by Basic Science Research Program of the National Research Foundation of Korea funded by the Ministry of Education (NRF-2021R1A2C1092925). We would like to acknowledge the Washington State Department of Health Prescription Drug Monitoring Program for collecting, cleaning, and providing the data used in this analysis. Additionally, we would like to acknowledge the Washington State Department of Social and Health Services Research and Data Analysis Team for providing the list of National Drug Codes used to identify buprenorphine drugs indicated for opioid use disorder treatment. Finally, we would like to acknowledge the Washington State Health Care Authority State Opioid Treatment Authority for their input on identifying the implementation date of the Comprehensive Addiction and Recovery Act, Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act, and other changes in buprenorphine prescribing policies during the COVID-19 public health emergency period in Washington State. We would also like to acknowledge Eugene Shin for supporting us with creating the data visualization for Figure A (available as a supplement to the online version of this article at https://ajph.org). This project was supported by grant 2019-PM-BX-0009 awarded by the Bureau of Justice Assistance. The Washington State Department of Health supported this analysis. C. Park\u2019s work was supported in part by Basic Science Research Program of the National Research Foundation of Korea funded by the Ministry of Education (NRF-2021R1A2C1092925).
| Funders | Funder number |
|---|---|
| Bureau of Justice Assistance | |
| National Research Foundation of Korea | |
| Washington State Department of Health | |
| Washington State Health Care Authority State Opioid Treatment Authority | |
| Ministry of Education China | NRF-2021R1A2C1092925 |
| Ministry of Education China |
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
