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Variations in US county‐level trends in buprenorphine use, 2018–2022.

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Title: Variations in US county‐level trends in buprenorphine use, 2018–2022.
Authors: Lefler, Taylor W., Chai, Grace, Goyal, Sonal, Song, Jaejoon, Xu, Jing, Weissburg, Lisa T., Muñoz, Monica A., Dal Pan, Gerald
Source: Addiction. Apr2026, Vol. 121 Issue 4, p934-943. 10p.
Subjects: Substance abuse, Drug overdose, Medical prescriptions, Cluster analysis (Statistics), Research funding, Scientific observation, Treatment effectiveness, Retrospective studies, Descriptive statistics, Opioid abuse, Medical records, Acquisition of data, Rural population, Confidence intervals, Data analysis software, Buprenorphine, Employment
Geographic Terms: United States
Abstract: Background and aims: Despite multiple interventions, national‐level trends of buprenorphine prescription use plateaued during a period of increasing opioid overdose deaths in the United States; county‐level use trends may provide additional insights. We aimed to analyze county‐level trends in buprenorphine treatment for opioid use disorder (OUD) and determine factors associated with trends. Design: In this retrospective study, we used an iterative hierarchical cluster analysis to group counties with similar buprenorphine prescription use trends and then compared characteristics between clusters. Setting: Retail pharmacy dispensing in the United States from 2018 to 2022. Participants: Data on prescriptions dispensed for buprenorphine medications labeled to treat OUD. Measurements We analyzed standardized mean differences (SMD) and 95% confidence intervals (CI) of county‐level characteristics between counties with varying trends in buprenorphine utilization. Findings Prescriptions dispensed for buprenorphine significantly increased in 924 counties (28% of US population) from 2018 to 2022 but declined in 839 counties (50%) from 2021 to 2022. Counties with decreasing (versus increasing) use had significantly higher opioid overdose death rates (SMD = −0.23; 95% CI = −0.34 to −0.13) and unemployment (SMD = −0.36; 95% CI = −0.46 to −0.27). Counties with increasing trends had higher percentages of residents in rural areas (SMD = 0.26; 95% CI = 0.16–0.35) and prescribing by nurse practitioners (SMD = 0.39; 95% CI = 0.29–0.48). Conclusions: From 2018 to 2022, buprenorphine use as treatment for opioid use disorder increased in some United States counties, notably counties with more residents living in rural areas and counties with more prescriptions written by nurse practitioners. However, declining use in other US counties suggest challenges persist in increasing access to medication for treament of opioid use disorder, hindering progress in addressing the opioid crisis. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Variations in US county‐level trends in buprenorphine use, 2018–2022.
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  Data: <searchLink fieldCode="AR" term="%22Lefler%2C+Taylor+W%2E%22">Lefler, Taylor W.</searchLink><br /><searchLink fieldCode="AR" term="%22Chai%2C+Grace%22">Chai, Grace</searchLink><br /><searchLink fieldCode="AR" term="%22Goyal%2C+Sonal%22">Goyal, Sonal</searchLink><br /><searchLink fieldCode="AR" term="%22Song%2C+Jaejoon%22">Song, Jaejoon</searchLink><br /><searchLink fieldCode="AR" term="%22Xu%2C+Jing%22">Xu, Jing</searchLink><br /><searchLink fieldCode="AR" term="%22Weissburg%2C+Lisa+T%2E%22">Weissburg, Lisa T.</searchLink><br /><searchLink fieldCode="AR" term="%22Muñoz%2C+Monica+A%2E%22">Muñoz, Monica A.</searchLink><br /><searchLink fieldCode="AR" term="%22Dal+Pan%2C+Gerald%22">Dal Pan, Gerald</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Apr2026, Vol. 121 Issue 4, p934-943. 10p.
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  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
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  Data: Background and aims: Despite multiple interventions, national‐level trends of buprenorphine prescription use plateaued during a period of increasing opioid overdose deaths in the United States; county‐level use trends may provide additional insights. We aimed to analyze county‐level trends in buprenorphine treatment for opioid use disorder (OUD) and determine factors associated with trends. Design: In this retrospective study, we used an iterative hierarchical cluster analysis to group counties with similar buprenorphine prescription use trends and then compared characteristics between clusters. Setting: Retail pharmacy dispensing in the United States from 2018 to 2022. Participants: Data on prescriptions dispensed for buprenorphine medications labeled to treat OUD. Measurements We analyzed standardized mean differences (SMD) and 95% confidence intervals (CI) of county‐level characteristics between counties with varying trends in buprenorphine utilization. Findings Prescriptions dispensed for buprenorphine significantly increased in 924 counties (28% of US population) from 2018 to 2022 but declined in 839 counties (50%) from 2021 to 2022. Counties with decreasing (versus increasing) use had significantly higher opioid overdose death rates (SMD = −0.23; 95% CI = −0.34 to −0.13) and unemployment (SMD = −0.36; 95% CI = −0.46 to −0.27). Counties with increasing trends had higher percentages of residents in rural areas (SMD = 0.26; 95% CI = 0.16–0.35) and prescribing by nurse practitioners (SMD = 0.39; 95% CI = 0.29–0.48). Conclusions: From 2018 to 2022, buprenorphine use as treatment for opioid use disorder increased in some United States counties, notably counties with more residents living in rural areas and counties with more prescriptions written by nurse practitioners. However, declining use in other US counties suggest challenges persist in increasing access to medication for treament of opioid use disorder, hindering progress in addressing the opioid crisis. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/add.70264
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        Text: English
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      – SubjectFull: Medical prescriptions
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      – SubjectFull: Buprenorphine
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      – SubjectFull: United States
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              Text: Apr2026
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