Researchers recently took a look at the prescribing patterns of the 50,000 or so medical practitioners qualified to prescribe buprenorphine formulas for the medication-assisted treatment (MAT) of opioid addiction. Their published results report that more than half of the prescriptions for this drug came from less than 5% of these practitioners (2,450 of them). The researchers also reported that this group of practitioners, consisting largely of primary care physicians, only treated an average of 124 patients each month, far below the top limit of 275 patients that can be treated at any one time.
It is notable that addiction specialists only comprised 4.4% of this group of high-prescribing medical practitioners. The only requirement for doctors to join this group of doctors treating addiction with buprenorphine is an eight-hour online course. It would seem, then, that more than 2,300 doctors are treating addiction without any professional training in this field beyond the basics of prescribing opioids for pain.
It is also doubtful that these thousands of high-prescribing practitioners are providing a full array of addiction treatment as defined by the Substance Abuse and Mental Health Services Administration. SAMHSA states:
No single treatment is appropriate for everyone. Treatment varies depending on the type of drug and the characteristics of the patients…Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems…Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment. Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships.
A person who is addicted to opioids who really wants to leave that life behind deserves our best care and services to recover his or her ability to live a new, drug-free life. It is possible that a practitioner who hands out buprenorphine to hundreds of patients each month and offers no other care is short-changing those patients.
You can also read a press release about this study here.