Wang Yun, Hu Tao, Chang Chih-Hung, Heshmatipour Matthew, Guo Jeff Jianfei, Roosan Moom R, Miotto Karen A
School of Pharmacy, Chapman University, 9401 Jeronimo Road, Irvine, CA, 92618, USA.
Department of Geography, Oklahoma State University, Stillwater, USA.
Sci Rep. 2025 Aug 9;15(1):29168. doi: 10.1038/s41598-025-07315-9.
Qualified clinicians previously required a practitioner waiver (i.e., "DATA-waiver" or "X-waiver") to offer buprenorphine, a medication for opioid use disorder (OUD). However, many counties in the US experience fewer buprenorphine prescriptions due to factors such as "DATA-waiver" providers underutilizing their buprenorphine prescribing ability. Our study aimed to compare the availability of active buprenorphine-prescribing clinicians in California to the Substance Abuse and Mental Health Services Administration (SAMSHA)-listed DATA waived prescribers under each 5-digit ZIP Code. This study utilized the buprenorphine prescription record data in 2021 from California's Controlled Substance Utilization Review and Evaluation System (CURES). The list of the locators for all DATA-waiver clinicians was obtained from the SAMHSA webpage. Among 1,600 ZIP Codes where patients resided, 62.1% housed DATA-waived physicians, and 57.8% had active buprenorphine-prescribing clinicians. A disproportional distribution between buprenorphine-prescribing clinicians and DATA-waived physicians was evident. Among physicians listed in the SAMHSA roster, not all were actively prescribing buprenorphine. Significant disparities in access to active prescribers and DATA waiver prescribers persist between rural and urban areas in California. Addressing these issues requires resource allocation and inter-professional collaboration. The 2022 Omnibus bill's policy changes hold promise, necessitating further effort into OUD-based policy changes.
合格的临床医生以前需要从业者豁免（即“DATA豁免”或“X豁免”）才能提供丁丙诺啡，这是一种用于治疗阿片类药物使用障碍（OUD）的药物。然而，由于“DATA豁免”提供者未充分利用其丁丙诺啡处方能力等因素，美国许多县的丁丙诺啡处方较少。我们的研究旨在比较加利福尼亚州开具丁丙诺啡的在职临床医生与物质滥用和精神健康服务管理局（SAMSHA）列出的每个5位邮政编码下获得DATA豁免的开处方者的情况。本研究利用了2021年加利福尼亚州管制物质使用审查和评估系统（CURES）中的丁丙诺啡处方记录数据。所有获得DATA豁免的临床医生的定位器列表来自SAMSHA网页。在患者居住的1600个邮政编码区域中，62.1%有获得DATA豁免的医生，57.8%有开具丁丙诺啡的在职临床医生。开具丁丙诺啡的临床医生和获得DATA豁免的医生之间存在不均衡分布。在SAMSHA名册上列出的医生中，并非所有人都在积极开具丁丙诺啡。加利福尼亚州农村和城市地区在获得在职开处方者和DATA豁免开处方者方面仍然存在显著差异。解决这些问题需要资源分配和跨专业合作。2022年综合法案的政策变化带来了希望，有必要进一步努力推动基于OUD的政策变革。
