Provider shortage a barrier to opioid dependence treatment, Avalere finds
- Midwestern and Mid-Atlantic states lack a sufficient number of providers to handle the opioid crisis sweeping the country, a new Avalere report warns.
- Eleven states — Iowa, Illinois, Maryland, Michigan, Missouri, North Carolina, New Hampshire, Ohio, Virginia, Wisconsin and West Virginia — plus the District of Columbia, have lower than average rates of providers certified to prescribe buprenorphine, a front-line medicine used to prevent relapse in people with opioid dependence.
- Nine other states — Arizona, Kentucky, Minnesota, Nevada, Oklahoma, South Carolina, South Dakota, Tennessee and Utah — have lower rates of providers per overdose than the national average. The U.S. experiences, on average, 1.6 opioid overdoses per buprenorphine prescriber, according to the report.
The federal government and states have been stepping up their efforts to confront the opioid crisis, which claimed the lives of 64,000 Americans in 2016. In October, President Donald Trump declared opioids a public health emergency, to give the issue more attention at the national level. His administration’s HHS budget proposal, released earlier this month, calls for $5 billion over five years in resources to fight the epidemic. Public health experts say far more funding is necessary to fight the epidemic, however.
Medication-assisted treatment (MAT) — considered the gold standard in addiction care — has strong support from addiction experts, the American Medical Association and Food and Drug Commissioner Scott Gottlieb. However, provider shortage issues could make access to treatment difficult. The Association of American Medical Colleges projects the current shortage could reach 105,000 by 2030, fueled by burnout, burdensome regulations and retirement of baby boomer practitioners.
To increase access to MAT, Congress passed the Comprehensive Addiction and Recovery Act of 2016, creating a federal waiver pathway for nurse practitioners and physician assistants to prescribe buprenorphine for opioid-related issues. The waiver caps the number of patient they can treat at 30 a year.
“Although more providers are now able to prescribe buprenorphine, there appears to be a shortage of prescribers in many states,” Clara Soh, a director at Avalere, said in a statement. “Evaluating ways to narrow this gap, including bringing state scope-of-practice laws into alignment with federal regulations, would enable policymakers to achieve their goal to expand access.”