{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:10:37Z","timestamp":1790014237886,"version":"4.0.1"},"reference-count":47,"publisher":"Weston Medical Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Background: The opioid overdose crisis affects approximately 2.1 million Americans with opioid use disorder (OUD). Buprenorphine is an effective treatment that reduces mortality and supports recovery, yet physician perceptions and behaviors influence its prescribing. Understanding these factors is crucial for expanding access. This study examines California physicians\u2019 prescribing behaviors regarding buprenorphine for OUD.Methods: A cross-sectional survey was conducted via Qualtrics among California physicians. In total, we received 101 completed responses, representing various specialties and practice environments. Descriptive and inferential statistical methods, including independent t-tests, Wilcoxon signed-rank tests, and Kruskal\u2013Wallis tests, were used to analyze the data and examine demographic differences in prescribing behaviors.Results: Most respondents indicated a low demand for buprenorphine treatment and disagreed with the adequacy of naloxone access in overdose situations. Many of the physicians did not view Drug Enforcement Administration (DEA) interference as a major concern and felt that stigma did not hinder their ability to treat OUD. Male physicians reported obtaining buprenorphine training to be more challenging than did their female counterparts. Physicians in suburban settings expressed greater concerns about DEA involvement than those in urban areas. Furthermore, physicians with a Drug Addiction Treatment Act-Waiver felt better supported and trained than those without one.Conclusion: This study sheds light on California physicians\u2019 views and behaviors regarding prescribing buprenorphine for OUD. The challenges related to required training for buprenorphine prescribing indicate an area that needs further research. Additionally, concerns about DEA regulations in suburban areas and limited access to naloxone in overdose situations highlight the need for targeted interventions.<\/jats:p>","DOI":"10.5055\/jom.0978","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:26:52Z","timestamp":1790011612000},"page":"405-414","source":"Crossref","is-referenced-by-count":0,"title":["Examining physicians\u2019 behaviors regarding buprenorphine prescribing for opioid use disorder"],"prefix":"10.5055","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3678-2166","authenticated-orcid":false,"given":"Khashayar","family":"Eshtiaghi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Bhatjire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryan Shokrollah","family":"Shirazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-7988","authenticated-orcid":false,"given":"Marc","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3008","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"105655","unstructured":"Centers for Disease Control and Prevention: Drug overdose deaths in the United States, 2003-2023. US Department of Health and Human Services. 2025. Available at https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db522.htm. Accessed July 31, 2025."},{"key":"105656","unstructured":"California Department of Public Health: Opioid-Related Overdose Deaths in California, 2022. Sacramento, CA: California Department of Public Health, 2025. Available at https:\/\/www.cdph.ca.gov\/Programs\/CCDPHP\/sapb\/CDPH%20Document%20Library\/2022OpioidOverdoseDeaths.pdf. Accessed July 31, 2025."},{"key":"105657","unstructured":"Dydyk AM, Jain N, Gupta M: Opioid Use Disorder. In StatPearls. Treasure Island, FL: StatPearls, 2024. Available at https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK553166\/. Accessed June 7, 2024."},{"key":"105658","unstructured":"Jesse C, Gunja MZ, Gee ED: Too many lives lost: Comparing overdose mortality rates and policy solutions across high-income countries. The Commonwealth Fund. 2022. Available at https:\/\/www.commonwealthfund.org\/blog\/2022\/too-manylives-lost-comparing-overdose-mortality-rates-policy-solutions. Accessed February 18, 2024."},{"key":"105659","doi-asserted-by":"crossref","unstructured":"Jones CM, Campopiano M, Baldwin G, et al.: National and state treatment need and capacity for opioid agonist medication-assisted treatment. Am J Public Health. 2015; 105(8): E55-E63. DOI: 10.2105\/ajph.2015.302664.","DOI":"10.2105\/AJPH.2015.302664"},{"key":"105660","doi-asserted-by":"crossref","unstructured":"Patrick SW, Richards MR, Dupont WD, et al.: Association of pregnancy and insurance status with treatment access for opioid use disorder. JAMA Netw Open. 2020; 3(8): E2013456. DOI: 10.1001\/jamanetworkopen.2020.13456.","DOI":"10.1001\/jamanetworkopen.2020.13456"},{"key":"105661","doi-asserted-by":"crossref","unstructured":"Connery HS: Medication-assisted treatment of opioid use disorder: Review of the evidence and future directions. Harv Rev Psychiatry. 2015; 23(2): 63-75. DOI: 10.1097\/hrp.0000000000000075.","DOI":"10.1097\/HRP.0000000000000075"},{"key":"105662","doi-asserted-by":"crossref","unstructured":"Harrison JM, Kerber R, Andraka-Christou B, et al.: State policies and buprenorphine prescribing by nurse practitioners and physician assistants. Med Care Res Rev. 2022; 79(6): 789-797. DOI: 10.1177\/10775587221086489.","DOI":"10.1177\/10775587221086489"},{"key":"105663","doi-asserted-by":"crossref","unstructured":"Krawczyk N, Rivera BD, Jent V, et al.: Has the treatment gap for opioid use disorder narrowed in the US? A yearly assessment from 2010 to 2019. Int J Drug Policy. 2022; 110: 103786. DOI: 10.1016\/j.drugpo.2022.103786.","DOI":"10.1016\/j.drugpo.2022.103786"},{"key":"105664","doi-asserted-by":"crossref","unstructured":"National Academies of Sciences, Engineering, and Medicine: Medications for Opioid Use Disorder save Lives. Washington, DC: National Academies Press, 2019. DOI: 10.17226\/25310.","DOI":"10.17226\/25310"},{"key":"105665","doi-asserted-by":"crossref","unstructured":"Santo T, Jr, Clark B, Hickman M, et al.: Association of opioid agonist treatment with all-cause mortality and specific causes of death among people with opioid dependence: A systematic review and meta-analysis. JAMA Psychiatry. 2021; 78(9): 979-993. DOI: 10.1001\/jamapsychiatry.2021.0976.","DOI":"10.1001\/jamapsychiatry.2021.0976"},{"key":"105666","doi-asserted-by":"crossref","unstructured":"Silwal A, Talbert J, Bohler RM, et al.: State alignment with federal regulations in 2022 to relax buprenorphine 30-patient waiver requirements. Drug Alcohol Depend Rep. 2023; 7: 100164. DOI: 10.1016\/j.dadr.2023.100164.","DOI":"10.1016\/j.dadr.2023.100164"},{"key":"105667","doi-asserted-by":"crossref","unstructured":"Sordo L, Barrio G, Bravo MJ, et al.: Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ. 2017: 357: j1550. DOI: 10.1136\/bmj.j1550.","DOI":"10.1136\/bmj.j1550"},{"key":"105668","doi-asserted-by":"crossref","unstructured":"Watts BV, Gottlieb DJ, Riblet NB, et al.: Association of medication treatment for opioid use disorder with suicide mortality. Am J Psychiatry. 2022; 179(4): 298-304. DOI: 10.1176\/appi.ajp.2021.21070700.","DOI":"10.1176\/appi.ajp.2021.21070700"},{"key":"105669","unstructured":"Health and Human Services Department: Practice guidelines for the administration of buprenorphine for treating opioid use disorder. Fed Regist. 2021; 86(80): 22439-22440. Available at https:\/\/www.federalregister.gov\/documents\/2021\/04\/28\/2021-08961\/practice-guidelines-for-the-administration-of-buprenorphine-for-treating-opioid-use-disorder. Accessed June 7, 2024."},{"key":"105670","doi-asserted-by":"crossref","unstructured":"McCollum CG, Eaton E, Creger T, et al.: Physicians\u2019 experiences with buprenorphine: A qualitative study of motivations for becoming X waivered and barriers to and facilitators of prescribing the medication for opioid use disorder. Drug Alcohol Depend. 2023; 244: 109777. DOI: 10.1016\/j.drugalcdep.2023.109777.","DOI":"10.1016\/j.drugalcdep.2023.109777"},{"key":"105671","doi-asserted-by":"crossref","unstructured":"Foti K, Heyward J, Tajanlangit M, et al.: Primary care physicians\u2019 preparedness to treat opioid use disorder in the United States: A cross-sectional survey. Drug Alcohol Depend. 2021; 225: 108811. DOI: 10.1016\/j.drugalcdep.2021.108811.","DOI":"10.1016\/j.drugalcdep.2021.108811"},{"key":"105672","doi-asserted-by":"crossref","unstructured":"Haffajee RL, Andraka-Christou B, Attermann J, et al.: A mixed-method comparison of physician-reported beliefs about and barriers to treatment with medications for opioid use disorder. Subst Abuse Treat Prev Policy. 2020; 15(1): 69. DOI: 10.1186\/s13011-020-00312-3.","DOI":"10.1186\/s13011-020-00312-3"},{"key":"105673","doi-asserted-by":"crossref","unstructured":"Lai B, Croghan I, Ebbert JO: Buprenorphine waiver attitudes among primary care providers. J Prim Care Community Health. 2022; 13: 1-5. DOI: 10.1177\/21501319221112272.","DOI":"10.1177\/21501319221112272"},{"key":"105674","unstructured":"H.R. 2617\u2014Consolidated Appropriations Act, 117th Cong.: 2022. Available at https:\/\/www.congress.gov\/bill\/117th-congress\/house-bill\/2617. Accessed July 14, 2024."},{"key":"105675","doi-asserted-by":"crossref","unstructured":"Jones CM, Diallo MM, Vythilingam M, et al.: Characteristics and correlates of US clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic. Drug Alcohol Depend. 2021; 225: 108783. DOI: 10.1016\/j.drugalcdep.2021.108783.","DOI":"10.1016\/j.drugalcdep.2021.108783"},{"key":"105676","doi-asserted-by":"crossref","unstructured":"Jones CM, McCance-Katz EF: Characteristics and prescribing practices of clinicians recently waivered to prescribe buprenorphine for the treatment of opioid use disorder. Addiction. 2019; 114(3): 471-482. DOI: 10.1111\/add.14436.","DOI":"10.1111\/add.14436"},{"key":"105677","doi-asserted-by":"crossref","unstructured":"Haffajee RL, Bohnert ASB, Lagisetty PA: Policy pathways to address provider workforce barriers to buprenorphine treatment. Am J Prev Med. 2018; 54(Suppl. 3): S230-S242. DOI: 10.1016\/j.amepre.2017.12.022.","DOI":"10.1016\/j.amepre.2017.12.022"},{"key":"105678","doi-asserted-by":"crossref","unstructured":"Nguemeni Tiako MJ, Meinhofer A, Friedman A, et al.: Buprenorphine uptake during pregnancy following the 2017 guidelines update on prenatal opioid use disorder. Am J Obstet Gynecol. 2022; 227(3): 544-546.e541. DOI: 10.1016\/j.ajog.2022.05.041.","DOI":"10.1016\/j.ajog.2022.05.041"},{"key":"105679","doi-asserted-by":"crossref","unstructured":"Rowe CL, Ahern J, Hubbard A, et al.: Evaluating buprenorphine prescribing and opioid-related health outcomes following the expansion of the buprenorphine waiver program. J Subst Abuse Treat. 2022; 132: 108452. DOI: 10.1016\/j.jsat.2021.108452.","DOI":"10.1016\/j.jsat.2021.108452"},{"key":"105680","unstructured":"United States Congress: Drug Addiction Treatment Act of 2000. Public Law 106-310, 2000: 2205-2206."},{"key":"105681","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA): Waiver elimination (MAT act). 2024. Available at https:\/\/www.samhsa.gov\/medication-assisted-treatment\/removal-data-waiver-requirement. Accessed June 8, 2024."},{"key":"105682","unstructured":"CMA, California Medical Association: Congress eliminates need for waiver to treat opioid use disorder. 2023. Available at https:\/\/www.cmadocs.org\/newsroom\/news\/view\/ArticleId\/50024\/Congress-eliminates-need-for-waiver-to-treatopioid-use-disorder. Accessed June 7, 2024."},{"key":"105683","doi-asserted-by":"crossref","unstructured":"Hutchinson E, Catlin M, Andrilla CH, et al.: Barriers to primary care physicians prescribing buprenorphine. Ann Fam Med. 2014; 12(2): 128-133. DOI: 10.1370\/afm.1595.","DOI":"10.1370\/afm.1595"},{"key":"105684","doi-asserted-by":"crossref","unstructured":"Molfenter T, Fitzgerald M, Jacobson N, et al.: Barriers to buprenorphine expansion in Ohio: A time-elapsed qualitative study. J Psychoactive Drugs. 2019; 51(3): 272-279. DOI: 10.1080\/02791072.2019.1566583.","DOI":"10.1080\/02791072.2019.1566583"},{"key":"105685","doi-asserted-by":"crossref","unstructured":"Lanham HJ, Papac J, Olmos DI, et al.: Survey of barriers and facilitators to prescribing buprenorphine and clinician perceptions on the Drug Addiction Treatment Act of 2000 Waiver. JAMA Netw Open. 2022; 5(5): e2212419. DOI: 10.1001\/jamanetworkopen.2022.12419.","DOI":"10.1001\/jamanetworkopen.2022.12419"},{"key":"105686","doi-asserted-by":"crossref","unstructured":"Andrilla CHA, Coulthard C, Larson EH: Barriers rural physicians face prescribing buprenorphine for opioid use disorder. Ann Fam Med. 2017; 15(4): 359-362. DOI: 10.1370\/afm.2099.","DOI":"10.1370\/afm.2099"},{"key":"105687","doi-asserted-by":"crossref","unstructured":"Lowenstein M, Kilaru A, Perrone J, et al.: Barriers and facilitators for emergency department initiation of buprenorphine: A physician survey. Am J Emerg Med. 2019; 37(9): 1787-1790. DOI: 10.1016\/j.ajem.2019.02.025.","DOI":"10.1016\/j.ajem.2019.02.025"},{"key":"105688","doi-asserted-by":"crossref","unstructured":"Molfenter T, Sherbeck C, Zehner M, et al.: Buprenorphine prescribing availability in a sample of Ohio specialty treatment organizations. J Addict Behav Ther Rehabil. 2015; 4(2): 1000140. DOI: 10.4172\/2324-9005.1000140.","DOI":"10.4172\/2324-9005.1000140"},{"key":"105689","doi-asserted-by":"crossref","unstructured":"Huhn AS, Dunn KE: Why aren\u2019t physicians prescribing more buprenorphine? J Subst Abuse Treat. 2017; 78: 1-7. DOI: 10.1016\/j.jsat.2017.04.005.","DOI":"10.1016\/j.jsat.2017.04.005"},{"key":"105690","doi-asserted-by":"crossref","unstructured":"DeFlavio JR, Rolin SA, Nordstrom BR, et al.: Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians. Rural Remote Health. 2015; 15: 3019.","DOI":"10.22605\/RRH3019"},{"key":"105691","doi-asserted-by":"crossref","unstructured":"Andrilla CHA, Jones KC, Patterson DG: Prescribing practices of nurse practitioners and physician assistants waivered to prescribe buprenorphine and the barriers they experience prescribing buprenorphine. J Rural Health. 2020; 36(2): 187-195. DOI: 10.1111\/jrh.12404.","DOI":"10.1111\/jrh.12404"},{"key":"105692","doi-asserted-by":"crossref","unstructured":"Gordon AJ, Kavanagh G, Krumm M, et al.: Facilitators and barriers in implementing buprenorphine in the Veterans health administration. Psychol Addict Behav. 2011; 25(2): 215-224. DOI: 10.1037\/a0022776.","DOI":"10.1037\/a0022776"},{"key":"105693","doi-asserted-by":"crossref","unstructured":"Netherland J, Botsko M, Egan JE, et al.: Factors affecting willingness to provide buprenorphine treatment. J Subst Abuse Treat. 2009; 36(3): 244-251. DOI: 10.1016\/j.jsat.2008.06.006.","DOI":"10.1016\/j.jsat.2008.06.006"},{"key":"105694","doi-asserted-by":"crossref","unstructured":"Turner BJ, Laine C, Lin YT, et al.: Barriers and facilitators to primary care or human immunodeficiency virus clinics providing methadone or buprenorphine for the management of opioid dependence. Arch Intern Med. 2005; 165(15): 1769-1776. DOI: 10.1001\/archinte.165.15.1769.","DOI":"10.1001\/archinte.165.15.1769"},{"key":"105695","doi-asserted-by":"crossref","unstructured":"McCarty D, Rieckmann T, Green C, et al.: Training rural practitioners to use buprenorphine: Using the change book to facilitate technology transfer. J Subst Abuse Treat. 2004; 26(3): 203-208. DOI: 10.1016\/s0740-5472(03)00247-2.","DOI":"10.1016\/S0740-5472(03)00247-2"},{"key":"105696","doi-asserted-by":"crossref","unstructured":"Sharma A, Kelly SM, Mitchell SG, et al.: Update on barriers to pharmacotherapy for opioid use disorders. Curr Psychiatry Rep. 2017; 19(6): 35. DOI: 10.1007\/s11920-017-0783-9.","DOI":"10.1007\/s11920-017-0783-9"},{"key":"105697","doi-asserted-by":"crossref","unstructured":"Walley AY, Alperen JK, Cheng DM, et al.: Office-based management of opioid dependence with buprenorphine: Clinical practices and barriers. J Gen Intern Med. 2008; 23(9): 1393-1398. DOI: 10.1007\/s11606-008-0686-x.","DOI":"10.1007\/s11606-008-0686-x"},{"key":"105698","doi-asserted-by":"crossref","unstructured":"Arfken CL, Johanson CE, di Menza S, et al.: Expanding treatment capacity for opioid dependence with office-based treatment with buprenorphine: National surveys of physicians. J Subst Abuse Treat. 2010; 39(2): 96-104. DOI: 10.1016\/J.JSAT.2010.05.004.","DOI":"10.1016\/j.jsat.2010.05.004"},{"key":"105699","unstructured":"Qualtrics: Qualtrics survey software. Provo, UT: Qualtrics, 2023. Available at https:\/\/www.qualtrics.com. Accessed November 20, 2025."},{"key":"105700","unstructured":"R Core Team: R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. 2024. Available at https:\/\/www.R-project.org. Accessed August 23, 2024."},{"key":"105701","unstructured":"Posit Team: RStudio: Integrated development environment for R. Posit Software, PBC. 2024. Available at https:\/\/posit.co."}],"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/4144\/4421","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/4144\/4421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:27:14Z","timestamp":1790011634000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/4144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,9,21]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.0978","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"value":"1551-7489","type":"electronic"},{"value":"1551-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}