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Substance Use and Addiction Medicine

Assessment of Filled Buprenorphine Prescriptions for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Internal Medicine

Published Online: December 21, 2020

Research Letter

Article Information and Disclosures

Thuy D. Nguyen, PhD¹;

Sumedha Gupta, PhD²;

Engy Ziedan, PhD³;

Kosali I. Simon, PhD⁴;

G. Caleb Alexander, MD, MS⁵;

Brendan Saloner, PhD⁶;

Bradley D. Stein, MD, PhD⁷

Author Affiliations

¹Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
²Department of Economics, Indiana University-Purdue University Indianapolis
³Department of Economics, Tulane University, New Orleans, Louisiana
⁴O’Neill School Public and Environmental Affairs, Indiana University Bloomington
⁵Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
⁶Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
⁷RAND Corporation, Pittsburgh, Pennsylvania

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The coronavirus disease 2019 (COVID-19) pandemic has profoundly disrupted health care delivery in the US.¹ The Centers for Disease Control and Prevention noted a 9.1% increase in reported 12-month counts of drug overdose deaths from March 2019 to March 2020, from 67 726 to 73 860.² On March 13, 2020, a COVID-19 national emergency was declared. To diminish potential barriers to treatment access, 3 days later, federal guidelines on telemedicine use were released, providing authorized practitioners increased flexibility to prescribe buprenorphine to patients with opioid use disorder (OUD) during this public health emergency.³ Other local, state, and federal policy initiatives have also attempted to preserve access to medication treatment for OUD, yet the cumulative outcome of these undertakings is not clear.

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Article Information

Accepted for Publication: October 24, 2020.

Published Online: December 21, 2020. doi:10.1001/jamainternmed.2020.7497

Corresponding Author: Thuy D. Nguyen, PhD, Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, M3234 SPH II, Ann Arbor, MI 48109 (thuydn@umich.edu).

Author Contributions: Dr Nguyen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Nguyen, Gupta, Ziedan, Simon.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Nguyen, Gupta, Ziedan, Simon, Stein.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Nguyen, Gupta, Ziedan.

Administrative, technical, or material support: Simon.

Supervision: Simon.

Conflict of Interest Disclosures: Dr Alexander reported being a past chair of the US Food and Drug Administration’s Peripheral and Central Nervous System Advisory Committee; serving as a paid adviser to IQVIA; being a cofounding principal and equity holder in Monument Analytics, a health care consultancy whose clients include the life sciences industry as well as plaintiffs in opioid litigation; and being a member of OptumRx's National P&T Committee. No other disclosures were reported.

Funding/Support: Dr Stein was supported by grant 1R01DA045800-01 from the National Institute on Drug Abuse during the conduct of the study.

Role of the Funder/Sponsor: The data sponsor was not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Disclaimer: The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of Symphony Health or any of its affiliated or subsidiary entities.

Additional Information: The data, technology, and services used in the generation of these research findings were supplied pro bono by the COVID-19 Research Database partners, who are acknowledged at https://covid19researchdatabase.org.

References

Cutler D . How will COVID-19 affect the health care economy? JAMA. 2020;323(22):2237-2238. doi:10.1001/jama.2020.7308 PubMed Google Scholar Crossref

Ahmad FB , Rossen LM SP . Provisional drug overdose death counts. National Center for Health Statistics. Reviewed September 16, 2020. Accessed October 10, 2020. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

American Society of Addiction Medicine. Access to buprenorphine in office-based settings: ASAM COVID-19 Task Force Recommendations. Published 2020. Accessed October 10, 2020. https://www.asam.org/Quality-Science/covid-19-coronavirus/access-to-buprenorphine

Stein BD , Sorbero M , Dick AW , Pacula RL , Burns RM , Gordon AJ . Physician capacity to treat opioid use disorder with buprenorphine-assisted treatment. JAMA. 2016;316(11):1211-1212. doi:10.1001/jama.2016.10542 PubMed Google Scholar Crossref

Centers for Disease Control and Prevention. Data resources: analyzing opioid prescription data and oral morphine milligram equivalents (MME), 2018 version. Reviewed October 9, 2020. Accessed January 8, 2020. https://www.cdc.gov/drugoverdose/resources/data.html

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.