Perceptions and practices addressing diversion among US buprenorphine prescribers.

Lin LA, Lofwall MR, Walsh SL, Gordon AJ, Knudsen HK. Perceptions and practices addressing diversion among US buprenorphine prescribers. Drug and Alcohol Dependence. 2018 May 1; 186:147-153.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

BACKGROUND: While there has been a dramatic increase in prescribing of buprenorphine for the treatment of opioid use disorder in the US, little is known about prescribers'' attitudes and practices regarding buprenorphine diversion and how they relate to prescriber characteristics. METHODS: A national random sample of buprenorphine prescribers (N? = 1174) completed surveys from July 2014 to January 2017. Analyses examined relationships between prescriber and practice characteristics and prescriber perceptions and approaches regarding diversion. RESULTS: Among this sample of buprenorphine prescribers, 79.0% (N? = 898) reported assessing all patients for risk of buprenorphine diversion and misuse. A third of prescribers described diversion as a significant or very significant concern in their community. The majority of prescribers reported seeing patients on average at least every other week during the first 60?days of treatment, and the majority reported testing urine for buprenorphine to assess for diversion. Perceptions of diversion being a greater problem in their community (AOR 1.212, 95% CI 1.073-1.369) and use of medication counts (AOR 1.006, 95% CI 1.003-1.009) were associated with increased likelihood of terminating patients when diversion was suspected, while having expertise in addiction (AOR 0.526, 95% CI 0.406-0.682) or psychiatry (AOR 0.714, 95% CI 0.558-0.914) were associated with decreased odds of terminating treatment for suspected diversion. CONCLUSIONS: Buprenorphine prescribers report diversion is an important issue, and most prescribers report that they assess patients for diversion, though specific practices differ based on prescriber and practice characteristics.