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Semin Neurol
DOI: 10.1055/s-0044-1787569
Review Article

Availability and Opportunities for Expansion of Buprenorphine for the Treatment of Opioid Use Disorder

Greer McKendrick
1   Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Samuel W. Stull
2   Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
,
Anjalee Sharma
3   Friends Research Institute, Baltimore, Maryland
,
Kelly E. Dunn
1   Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

There is an urgent need to expand access to treatment for persons with opioid use disorder (OUD). As neurologists may frequently encounter patients with chronic pain who have developed OUD, they are in a position to serve as advocates for treatment. Buprenorphine is the most scalable medication for OUD in the United States, yet expansion has plateaued in recent years despite growing treatment needs. Reluctance of providers to establish treatment with new patients, challenges with rural expansion, stigma related to buprenorphine-based care, and pharmacy pressures that incentivize low dispensing and inventories may have stalled expansion. This review introduces these challenges before outlining actionable and evidenced-based strategies that warrant investigation, including methods to improve patient access to care (remotely delivered care, mobile delivery programs, Bridge programs) and provider retention and confidence in prescribing (expert consults, Extension for Community Healthcare Outcomes, a telementoring model, hub-and-spoke services), as well as novel innovations (virtual reality, artificial intelligence, wearable technologies). Overall, fortifying existing delivery systems while developing new transformative models may be necessary to achieve more optimal levels of buprenorphine treatment expansion.

Keywords

opioid - opioid use disorder - buprenorphine - Suboxone - treatment - review


Publication History

Article published online:
14 June 2024

© 2024. Thieme. All rights reserved.

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