Clement J Zablocki Wis Veteran Administration Medical Center, Milwaukee, Wis.
Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Am J Med. 2024 Mar;137(3):280-283. doi: 10.1016/j.amjmed.2023.11.004. Epub 2023 Nov 19.
Buprenorphine is effective for the treatment of opioid use disorder and chronic pain, has a safer pharmacological profile than full mu-opioid agonists, and can now be prescribed by any US provider with a Drug Enforcement Administration license. This study aimed to examine a decade of buprenorphine prescribing patterns in the United States.
We abstracted opioid and buprenorphine prescribing patterns, including patient characteristics, from the 2010-2019 National Ambulatory Medical Care Survey, a national probability sample of non-federal, ambulatory encounters.
Among 248,164 ambulatory encounters, opioids were prescribed 2.6%-4.3% of the time with a rate that peaked in 2013 and has been steadily declining. Buprenorphine was infrequently prescribed. Patients receiving buprenorphine were predominantly male (59%), white (70%), younger in age, and had higher rates of substance use disorder (72%).
Buprenorphine is infrequently used, despite being effective for pain and safer than full mu-opioid agonists. The Drug Enforcement Administration recently ended the requirement for prescribers to obtain an X-waiver, which may increase the rate of buprenorphine use among US practitioners.
丁丙诺啡对于治疗阿片类药物使用障碍和慢性疼痛有效，其药理学特征比完全的 μ 阿片受体激动剂更安全，且现在可由拥有美国缉毒局许可证的任何医疗服务提供者开具处方。本研究旨在考察美国丁丙诺啡处方模式的十年变化。
我们从 2010-2019 年全国门诊医疗调查中提取了阿片类药物和丁丙诺啡的处方模式，包括患者特征，该调查是一个非联邦、门诊就诊的全国概率样本。
在 248164 次门诊就诊中，阿片类药物的处方率为 2.6%-4.3%，在 2013 年达到峰值，此后一直在稳步下降。丁丙诺啡的使用频率较低。接受丁丙诺啡治疗的患者主要为男性（59%）、白人（70%）、年龄较小，且物质使用障碍的发生率较高（72%）。
尽管丁丙诺啡对疼痛有效且安全性优于完全的 μ 阿片受体激动剂，但使用频率仍较低。美国缉毒局最近取消了对处方者获得 X 豁免的要求，这可能会增加美国从业者使用丁丙诺啡的比例。
