Buprenorphine

There is substantial variability in who is prescribed buprenorphine, and understanding current gaps and unequal outcomes among various populations with opioid use disorder is critically important when supporting the implementation of buprenorphine prescribing in specific settings and locations.

Evidence for the intervention

Evidence supporting opioid overdose education and naloxone distribution (OEND) programs is summarized in at least eight systematic reviews. These draw mostly from observational study designs, including case series, cohort studies, and quality improvement studies. There are very few randomized controlled trials evaluating OEND programs, largely due to the overwhelming body of real-world evidence supporting naloxone distribution; this is common for interventions with substantial face-value credibility, such as parachutes or epinephrine pens. The few existing randomized controlled trials of OEND programs tend to compare one OEND implementation strategy to another OEND implementation strategy

Evidence-based Scale

Multiple studies have shown differences in who is prescribed buprenorphine, with respect to age, race/ethnicity, urban vs rural location, insurance status, income, and treatment access. These differences in who is prescribed buprenorphine, and the dosages that they are prescribed, ultimately contribute to unequal outcomes in opioid use disorder treatment engagement and long-term health. These differences could be addressed during implementation by designing strategies that acknowledge the reasons for observed differences in buprenorphine prescribing, such as preferences for buprenorphine type or higher dose, accessibility of a retail pharmacy for buprenorphine prescription filling, and types of follow-up care offered for continued buprenorphine prescribing.