{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:28:46Z","timestamp":1792664926789,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Prescribing medications for opioid use disorders (MOUD), including buprenorphine, naltrexone, and methadone, to adolescents remains an underused evidence-based strategy for reducing harms associated with opioid use.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To identify potential associations between clinician- and community-level characteristics regarding clinicians\u2019 self-reported willingness to prescribe MOUD to adolescents.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study included a phone survey of Indiana clinicians and spatial analysis of community-level characteristics. Clinicians were eligible for inclusion in analyses if actively providing health care and listed on the Buprenorphine Practitioner Locator website, a publicly available national registry of clinicians possessing a waiver to legally prescribe buprenorphine (ie, waivered clinicians).<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Community-level characteristics, including total population, rurality or urbanicity, percentage with incomes below the federal poverty line, and racial or ethnic makeup.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Clinicians were asked about their willingness to prescribe MOUD to adolescents younger than 18 years if clinically indicated. Responses were recorded as no, yes, or yes with conditions.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 871 clinicians listed on the website as of July 2022, 832 were eligible for inclusion and contacted by phone. Among waivered clinicians, 759 (91.2%) reported being unwilling to prescribe MOUD to adolescents, 73 clinicians (8.8%) reported willingness to prescribe MOUD to adolescents, and only 24 (2.9%) would do so without conditions. A multivariable logistic regression model including spatially lagged community-level variables showed that, among areas with waivered clinicians, clinicians practicing in more populated areas were significantly less likely to prescribe to adolescents (\u03b2\u2009=\u20090.65; 95% CI, 0.49-0.87;\n P<\/jats:italic>\n \u2009=\u2009.003). Similarly, those in more rural areas were significantly more likely to prescribe to adolescents (\u03b2\u2009=\u20091.27; 95% CI, 1.02-1.58;\n P<\/jats:italic>\n \u2009=\u2009.03). Variation in clinician willingness to prescribe was not explained by other community-level characteristics. Among all waivered clinicians, advanced practice clinicians were less likely than physicians to report willingness to prescribe (\u03b2\u2009=\u20090.58; 95% CI, 0.35-0.97;\n P<\/jats:italic>\n \u2009=\u2009.04), as were physicians without any specialty training relevant to MOUD prescribing when compared with family medicine clinicians (\u03b2\u2009=\u20090.40; 95% CI, 0.18-0.89;\n P<\/jats:italic>\n \u2009=\u2009.03). A small subgroup of waivered clinicians had training in pediatrics (13 clinicians [1.6%]), and none were willing to prescribe MOUD to adolescents.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n From this cross-sectional study, it appears that Indiana adolescents continued to face gaps in access to MOUD treatment, despite its well-established efficacy. Programs that support primary care practitioners, including family medicine clinicians and pediatricians, in safe and appropriate use of MOUD in adolescents may bridge these gaps.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.35416","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T17:40:15Z","timestamp":1727286015000},"page":"e2435416","source":"Crossref","is-referenced-by-count":9,"title":["Clinician Willingness to Prescribe Medications for Opioid Use Disorder to Adolescents in Indiana"],"prefix":"10.1001","volume":"7","author":[{"given":"Matthew C.","family":"Aalsma","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren A.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, University of Tennessee Health Science Center, 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