Anne Arundel County Department of Health Buprenorphine Expansion Office
Significance and Background
Anne Arundel County residents have been hard hit by the nationwide opioid epidemic, as evidenced by the 171 percent increase in overdoses from 2014 to 2017. This trend continued into 2018, with an ever-increasing number of opioid-related fatalities. The public health implications of this epidemic are devastating and continue to spread.
Since its FDA approval in 2002, the medical use of buprenorphine (bup) has increased by 2318 percent1, the number of tablets sold has increased exponentially, and this treatment remains in great demand. Despite the increase in bup prescribing, a significant geographic maldistribution of physicians with Drug Addiction Treatment Act 2000 (DATA)-waivers exists, with the majority of these prescribers located in urban areas. This geographical disparity is clearly reflected in treatment availability throughout Anne Arundel County.
There is a shortage of office-based opioid treatment programs in the county, despite the abundance of research proving its effectiveness in opioid use disorder treatment. The lack of primary care physicians providing this service in the county has created a market for cash-only physicians. Patients who are unable to afford this concierge medicine are left with few options. In order to close this gap, a strategic plan has been developed to implement a network of bup services within the county and integrate all service providers into a functional continuum of care.
The scientific evidence demonstrating the effectiveness of medication for opioid use disorder (OUD) is strong. Results from randomized controlled clinical trials, cohort studies, meta-analyses and reviews all support the practice of medication assisted treatment for patients with OUD. The literature consistently shows that bup can be successfully utilized in office-based settings, including primary care practices, to:
- Improve treatment engagement
- Reduce illicit opioid use
- Diminish physical dependency
- Prevent overdose
- Decrease mortality
This guide provides information on how expanding bup prescribing can improve treatment outcomes and reduce fatal overdoses in Anne Arundel County.