Clinical pharmacist practitioners prescribing of buprenorphine for opioid use disorder.

Baylis, Jorgenson, Pals, Hwang, Colvard, Alliu, Moore, Lin, Wyse, Hawkins, Hagedorn, Gordon. Clinical pharmacist practitioners prescribing of buprenorphine for opioid use disorder. Drug and Alcohol Dependence. 2025 Jun 1; 271:112663, DOI: 10.1016/j.drugalcdep.2025.112663.

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Abstract:

BACKGROUND: Clinical Pharmacist Practitioners (CPPs) have a long history of collaborating with other prescribers for the provision of buprenorphine medication treatment for opioid use disorder (B-MOUD). In January 2023, with the removal of the DATA 2000 X-waiver process, CPPs were allowed to prescribe B-MOUD in states that allow CPP prescriptive authority of controlled substances. We sought to examine CPP prescribing patterns of B-MOUD in a large heath care system in 2023. METHODS: We conducted a retrospective cohort study of patients with opioid use disorder (OUD) who received B-MOUD care in 2023 within the Veterans Health Administration (VHA). B-MOUD was defined as a formulation of buprenorphine indicated for OUD. We characterized Veterans who were prescribed B-MOUD by CPPs and examined the characteristics of these prescriptions and the episodes of care (EOC). RESULTS: In 2023, 22,863 Veterans received B-MOUD; 1090 (4.8 %) from a CPP. Veterans prescribed B-MOUD by CPPs were primarily 36-50 years old (n  =  419, 38.4 %), male (n  =  987, 90.6 %), white (n  =  987, 90.6 %), non-Hispanic/Latino (n  =  1043, 95.7 %), and in urban areas (n  =  648, 59.4 %). 110 CPPs prescribed B-MOUD in 36 states representing 1.9 % of all B-MOUD prescribers in 2023. CPPs prescribed 5258 B-MOUD prescriptions, conducted 339 (2.7 %) initiations, were involved in 1162 (4.2 %) of all EOC throughout the year, and were the sole prescriber for 16.6 % of EOC. CPP-involved EOC had 86.9 % (n  =  867) 90-day retention. CONCLUSION: When they were able to, VHA CPPs were early adopters in prescribing B-MOUD. B-MOUD prescribing by CPPs is an emerging opportunity to further expand access to B-MOUD.