Cover: Buprenorphine Treatment Episodes During the First Year of COVID

Buprenorphine Treatment Episodes During the First Year of COVID

A Retrospective Examination of Treatment Initiation and Retention

Published in: Journal of General Internal Medicine, Volume 38, Issue 3, pages 733-737 (February 2023). doi: 10.1007/s11606-022-07891-w

Posted on rand.org May 2, 2023

by Bradley D. Stein, Rachel Landis, Yaou Flora Sheng, Brendan Saloner, Adam J. Gordon, Mark J. Sorbero, Andrew W. Dick

Background

During the COVID pandemic, overall buprenorphine treatment appeared to remain relatively stable, despite some studies suggesting a decrease in patients starting buprenorphine. There is a paucity of empirical information regarding patterns of buprenorphine treatment during the pandemic.

Objective

To better understand the patterns of buprenorphine episodes during the pandemic and how those patterns compared to pre-pandemic patterns.

Design

Pharmacy claims representing approximately 92% of all prescriptions filled at retail pharmacies in all 50 U.S. states and the District of Columbia.

Participants

Individuals filling buprenorphine prescriptions indicated for treatment of opioid use disorder.

Main Measures

The number of active, starting, and ending buprenorphine treatment episodes March 13 to December 1, 2020, and the expected number of such episodes in 2020 based on the growth in treatment episodes from March 13 to December 1, 2019.

Key Results

The observed number of active buprenorphine episodes in December 2020 was comparable to the expected number, but new treatment episodes starting between March 13 and December 1, 2020, were 17.2% fewer than expected based on the 2019 experience. Similarly, the number of episodes that ended between March 13 and December 1, 2020, was 16.0% fewer than expected. Decreases from expected episode starts and ends occurred throughout the period but were greatest in the 2 months after the declaration of the public health emergency.

Conclusions and Relevance

Beneath the apparent stability of buprenorphine patient numbers during the pandemic, the flow of individuals receiving buprenorphine treatment changed substantially. Our findings shed light on how policy changes meant to support buprenorphine prescribing influenced prescribing dynamics during that period, suggesting that while policy efforts may have been successful in maintaining existing patients in treatment, that success did not extend to individuals not yet in treatment.

Research conducted by

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