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Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data

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Abstract

Research has examined the safety, efficacy, feasibility, and cost-effectiveness of buprenorphine for the treatment of opioid dependence, but few studies have examined patient and provider experiences, especially in community health centers. Using de-identified electronic health record system (EHRS) data from 70 OCHIN community health centers (n = 1825), this cross-sectional analysis compared the demographics, comorbidities, and service utilization of patients receiving buprenorphine to those not receiving medication-assisted treatment (MAT). Compared to non-MAT patients, buprenorphine patients were younger and less likely to be Hispanic or live in poverty. Buprenorphine patients were less likely to have Medicaid insurance coverage, more likely to self-pay, and have private insurance coverage. Buprenorphine patients were less likely to have problem medical comorbidities or be coprescribed high-risk medications. It is important for providers, clinic administrators, and patients to understand the clinical application of medications for opioid dependence to ensure safe and effective care within safety net clinics.

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Authors and Affiliations

  1. OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239-3098, USA

    Traci R. Rieckmann PhD

  2. Department of Family Medicine, Oregon Health & Science University, Portland, OR, 97239-3098, USA

    Nicholas Gideonse MD & Amanda Risser MD, MPH

  3. OCHIN Community Health Information Network, Portland, OR, 97201-5195, USA

    Jennifer E. DeVoe MD

  4. Department of Public Administration and Policy, University of Georgia, Athens, GA, 30602, USA

    Amanda J. Abraham PhD

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  1. Traci R. Rieckmann PhD
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  2. Nicholas Gideonse MD
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  3. Amanda Risser MD, MPH
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  4. Jennifer E. DeVoe MD
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Correspondence to Traci R. Rieckmann PhD.

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Financial Support

This research was supported by grant no. K23 DA021225 from the National Institutes of Drug Abuse (NIDA). The OCHIN infrastructure was supported by grant no. 1RC4LM010852 from the National Institutes of Health (NIH), National Library of Medicine, and grant no. UB2HA20235 from the Health Resources and Services Administration (HRSA).

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The authors declare that they have no conflicts of interest.

Additional information

Some preliminary findings from this data were presented at the Addiction Health Services Research Conference in New York on October 18, 2012, in a symposium titled “Primary Care and Substance Use Disorders: Availability of Services, Financing and Treatment Options.”

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Rieckmann, T.R., Gideonse, N., Risser, A. et al. Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data. J Behav Health Serv Res 44, 351–363 (2017). https://doi.org/10.1007/s11414-017-9553-z

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