Supply of Physicians Waivered to Treat Opioid Addiction in Rural America: Policy Options to Remedy Critical Shortages

Research center:
Lead researcher:
Project funded:
September 2012
Project completed:
August 2014

Problem statement: Unintentional drug overdose deaths associated with prescription opioids rose 395% between 1999 and 2007, and opiate misuse among adolescents is now twice as common as in the 1990s. Because methadone maintenance clinics are largely non-existent in rural areas, an effective alternative is training physicians in the use of buprenorphine, an effective addiction treatment that can be administered in outpatient practices.

Project goals: A key aim of the Drug Addiction Treatment Act of 2000, a federal law that permits physicians to prescribe buprenorphine, is providing office-based accessible care for patients addicted to opioids in the rural US Because little is known about this workforce, our national study will cover all 20,604 physicians who had received a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine for the treatment of opioid addiction as of 2011, describing them by age, sex, specialty, rurality and practice type.

Methods: Using secondary data from the DEA and the AMA Masterfile, we will aggregate waivered physicians into urban and rural area types, and identify their practices as private, public, or part of a public safety net organization. Measures: Waivered physicians will be described by age, sex, specialty, rurality and practice type. Measures of assumed need, such as rates of opiate use in the population, and rates of opiate-associated deaths will be developed and contrasted with the availability of buprenorphine providers.