Geospatial and Social Determinants of Access to Buprenorphine Providers and Pharmacies

Treatment with buprenorphine is an evidence-based and effective approach to the clinical management of opioid use disorder. Unlike other forms of medication for opioid use disorder, buprenorphine can be dispensed directly to patients as a multi-day prescription from a community pharmacy pursuant to a prescription. This is intended to maximize access and convenience of care. Emerging evidence, however, suggests that filling a prescription for buprenorphine is not as easy as filling a prescription for any other medication. Not all pharmacies dispense buprenorphine. In data from the Texas Prescription Monitoring Program, only 53% of all outpatient community pharmacies dispensed at least one buprenorphine prescription in 2020. Furthermore, very few pharmacies dispense to more than a handful of patients. In Texas, 10% of community pharmacies that dispense buprenorphine (roughly 5% of all pharmacies in the state), dispense to 55% of all patients, indicating that access to treatment is highly concentrated. These phenomena are not localized to Texas. In a recent telephone audit of pharmacies in eleven states, researchers showed that, overall, only 48.3% of pharmacies had buprenorphine in stock with availability ranging from 31.0%-85.6% in each state.

In this session, the presenters will explain how socioeconomic characteristics impact access to treatment for opioid use disorder through providers and pharmacies. They also will address how stability of access impacts adherence to treatment and influences risk of opioid-related harm. They will conclude by providing practical guidance for providers to help their patients access and maintain access to buprenorphine.