{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:39:28Z","timestamp":1781311168473,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009210","name":"Food and Drug Administration","doi-asserted-by":"publisher","award":["U01FD007064"],"award-info":[{"award-number":["U01FD007064"]}],"id":[{"id":"10.13039\/100009210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000038","name":"U.S. Food and Drug Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims, Design and Setting<\/jats:title><jats:p>We sought to describe longitudinal trends in buprenorphine receipt and buprenorphine\u2010waivered providers in the United States from 2003 to 2021 and measure whether the relationship between the two differed after capacity\u2010building strategies were enacted nationally in 2017. This was a retrospective study of two separate cohorts covering the years 2003\u201321, testing whether the association between two trends in these cohorts changed comparing 2003 to 2016 and from 2017 to 2021, among buprenorphine providers in the United States, regardless of treatment setting. Patients receiving dispensed buprenorphine at retail pharmacies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>All providers who have obtained a waiver to prescribe buprenorphine in the United States, and an estimate of the annual number of patients who had buprenorphine for opioid use disorder (OUD) dispensed to them at a retail pharmacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We synthesized and summarized data from multiple sources to assess the cumulative number of buprenorphine\u2010waivered providers over time. We used national\u2010level prescription data from IQVIA to estimate annual buprenorphine receipt for OUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>From 2003 to 2021, the number of buprenorphine\u2010waivered providers in the United States increased from fewer than 5000 in the first 2\u2009years of Food and Drug Administration (FDA) approval to more than 114\u2009000 in 2021, while patients receiving buprenorphine products for OUD increased from approximately 19\u2009000 to more than 1.4 million. The strength of association between waivered providers and patients is significantly different before and after 2017 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). From 2003 to 2016, for each additional provider, there was an average increase of 32.1 [95% confidence interval (CI)\u2009=\u200928.7\u201335.6] patients, but an increase of only 4.6 (95% CI=\u20093.5\u20135.7) patients for each additional provider, beginning in 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the United States, the relationship between the rates of growth in buprenorphine providers and patients became weaker after 2017. While efforts to increase buprenorphine\u2010waivered providers were successful, there was less success in translating that into significant increases in buprenorphine receipt.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16291","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T05:34:21Z","timestamp":1689140061000},"page":"2215-2219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The association between longitudinal trends in receipt of buprenorphine for opioid use disorder and buprenorphine\u2010waivered providers in the United States"],"prefix":"10.1111","volume":"118","author":[{"given":"Erin J.","family":"Stringfellow","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tse Yang","family":"Lim","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health  Boston MA USA"},{"name":"MIT Sloan School of Management  Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiru","family":"Dong","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3488-5903","authenticated-orcid":false,"given":"Ziyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6769-2732","authenticated-orcid":false,"given":"Mohammad S.","family":"Jalali","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School  Boston MA USA"},{"name":"MIT Sloan School of Management  Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-018-0094-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103786"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15458"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1543382"},{"key":"e_1_2_9_6_1","first-page":"1639","article-title":"Beyond the X\u2014next steps in policy reforms to address the overdose","volume":"388","author":"Wakeman SE","year":"2023","journal-title":"Crisis"},{"key":"e_1_2_9_7_1","unstructured":"Public law 114\u2010198. Comprehensive Addiction and Recovery Act of 2016.Washington D.C. United States of America:\u00a0U.S. Government Publishing Office;\u00a02016.\u00a0Available\u00a0from:https:\/\/www.congress.gov\/114\/plaws\/publ198\/PLAW-114publ198.pdf"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108032"},{"key":"e_1_2_9_9_1","volume-title":"Substance Abuse and Mental Health Services Administration 2021 report to Congress on the State Opioid Response Grants (SOR)","author":"Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment","year":"2021"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-2403"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.5996"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900635"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.18913"},{"key":"e_1_2_9_14_1","unstructured":"US Drug Enforcement Administration (DEA).Diversion Control Division. DEA\u2014qualifying practitioners by state. Available fromhttps:\/\/apps.deadiversion.usdoj.gov\/RAPR\/raprRegistrantPopulationByBusinessActivity.xhtml?jfwid=NCfboB71AH6pTbonosE69q\u2010RY\u2010riTP0dA2Xo0s0R:2#no\u2010back\u2010button. Accessed 7 Nov 2022."},{"key":"e_1_2_9_15_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Practitioner and program data.2022. Available fromhttps:\/\/www.samhsa.gov\/medication-assisted-treatment\/practitioner-resources\/data-program-data. Accessed 24 Aug 2022."},{"key":"e_1_2_9_16_1","volume-title":"IQVIA. The Uniform System of Classification (USC)","author":"Hunkler R","year":"2018"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/1910133"},{"key":"e_1_2_9_18_1","volume-title":"R: A Language Environment for Statistical Computing","author":"R Core Team","year":"2022"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.4469"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001153"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.13260"},{"key":"e_1_2_9_22_1","unstructured":"StringfellowEJ HumphreysK JalaliMS.Removing The X\u2010Waiver is one small step toward increasing treatment of opioid use disorder but great leaps are needed. Health Affairs Blog April 22 2021.https:\/\/doi.org\/10.1377\/hblog20210419.311749"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.12419"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.1903659"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06257-4"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.3673"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2019.1605372"},{"key":"e_1_2_9_28_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Substance Abuse and Mental Health Services Administration (SAMHSA)\u2019s public online data analysis system (PDAS). Treatment episode data set\u2014admissions (TEDS\u2010A)\u2014concatenated 2000 to 2019. Available from\/\/pdas.samhsa.gov\/#\/survey\/TEDS\u2010A\u20102000\u20102019\u2010DS0001\/crosstab\/?row=METHUSE&column=ADMYR&run_chisq=false&filter=METHUSE!%3D\u20109&results_received=true. 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