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Loosening MAT Prescribing Rules Did Not Increase Proportion of Overdose Deaths Involving Buprenorphine
The proportion of opioid overdose deaths involving the medication buprenorphine did not increase in the months after prescribing flexibilities were enacted during the COVID-19 pandemic, according to new research from the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention (CDC).
The findings, which were published on Friday in JAMA Network Open, follow a separate study conducted in 2021 which found that increasing take-home methadone doses to treat opioid use disorder (OUD) did not worsen treatment outcomes.
Researchers reviewed data for 46 states and Washington, D.C., from the CDC’s State Unintentional Drug Overdose Reporting System (SUDORS) from July 2019 to June 2021. During the study period, buprenorphine was involved in 2.2% of all drug overdose deaths and 2.6% of overdose deaths involving opioids. Between April 2020 and June 2021, the period during which buprenorphine prescribing regulations were loosened as a result of COVID-19, opioid overdose deaths increased, however the proportion of those deaths involving buprenorphine did not.
Further, 92.7% of buprenorphine-involved overdose deaths involved at least 1 other drug, compared to 67.2% of deaths involving an opioid other than buprenorphine. Overdose deaths involving buprenorphine were also less likely to involve illicit fentanyl.
“These findings help us better understand the circumstances of overdose deaths involving buprenorphine, which is crucial in our ability to inform policy, ensure safety, and improve clinical outcomes for people with substance use disorders,” Lauren Tanz, ScD., study lead author and an epidemiologist at CDC’s National Center for Injury Prevention and Control, said in a news release. “It is important to note the presence of other drugs in overdose deaths involving buprenorphine. The complex nature of substance use disorders and polysubstance use requires specific strategies to address it.”
Overall, nearly 107,000 drug overdose deaths were reported in 2021, with about 75% involving an opioid. Still, just 22% of individuals with an OUD receive medication-assisted treatment (MAT). NIDA Director Nora Volkow, MD, senior author on the study, said the findings published this month could help support the case for adapting MAT prescribing policies to increase access to treatment.
“Research has shown beyond a doubt that medications for opioid use disorder are overwhelmingly beneficial and can be lifesaving, yet they continue to be vastly underused,” Volkow said. “Expanding more equitable access to these medications for people with substance use disorders is a critical part of our nation’s response to the overdose crisis. The findings from this study strengthen existing evidence suggesting that greater flexibility in prescribing may be one safe method for working toward this goal.”
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