{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:26:56Z","timestamp":1791725216133,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000015","name":"U.S. Department of Energy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Despite multiple interventions, national\u2010level trends of buprenorphine prescription use plateaued during a period of increasing opioid overdose deaths in the United States; county\u2010level use trends may provide additional insights. We aimed to analyze county\u2010level trends in buprenorphine treatment for opioid use disorder (OUD) and determine factors associated with trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this retrospective study, we used an iterative hierarchical cluster analysis to group counties with similar buprenorphine prescription use trends and then compared characteristics between clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Retail pharmacy dispensing in the United States from 2018 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data on prescriptions dispensed for buprenorphine medications labeled to treat OUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>We analyzed standardized mean differences (SMD) and 95% confidence intervals (CI) of county\u2010level characteristics between counties with varying trends in buprenorphine utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Prescriptions dispensed for buprenorphine significantly increased in 924 counties (28% of US population) from 2018 to 2022 but declined in 839 counties (50%) from 2021 to 2022. Counties with decreasing (versus increasing) use had significantly higher opioid overdose death rates (SMD = \u22120.23; 95% CI = \u22120.34 to \u22120.13) and unemployment (SMD = \u22120.36; 95% CI = \u22120.46 to \u22120.27). Counties with increasing trends had higher percentages of residents in rural areas (SMD = 0.26; 95% CI = 0.16\u20130.35) and prescribing by nurse practitioners (SMD = 0.39; 95% CI = 0.29\u20130.48).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>From 2018 to 2022, buprenorphine use as treatment for opioid use disorder increased in some United States counties, notably counties with more residents living in rural areas and counties with more prescriptions written by nurse practitioners. However, declining use in other US counties suggest challenges persist in increasing access to medication for treament of opioid use disorder, hindering progress in addressing the opioid crisis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70264","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:13:32Z","timestamp":1765174412000},"page":"934-943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Variations in US county\u2010level trends in buprenorphine use, 2018\u20132022"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-9391","authenticated-orcid":false,"given":"Taylor W.","family":"Lefler","sequence":"first","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-723X","authenticated-orcid":false,"given":"Grace","family":"Chai","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-4473","authenticated-orcid":false,"given":"Sonal","family":"Goyal","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9022-5046","authenticated-orcid":false,"given":"Jaejoon","family":"Song","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, Office of Translational Sciences, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7654-0287","authenticated-orcid":false,"given":"Jing","family":"Xu","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4579-5141","authenticated-orcid":false,"given":"Lisa T.","family":"Weissburg","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9754-1986","authenticated-orcid":false,"given":"Monica A.","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4874-5864","authenticated-orcid":false,"given":"Gerald","family":"Dal Pan","sequence":"additional","affiliation":[{"name":"Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research US Food and Drug Administration  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics.National Vital Statistics System Mortality 2018\u20132022 on CDC WONDER Online Database [Internet]. 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