Access to opioid meds varies by pharmacy, study finds
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Patients seeking medication-assisted treatment for opioid use disorder may face significant barriers in accessing those life-saving drugs even after obtaining a prescription, according to a new study from Oregon State University and Johns Hopkins University.
Why it matters: Researchers found pharmacies in more racially segregated and low-income areas across the U.S. were less likely to carry buprenorphine — one of few drugs considered to be the gold standard for treating opioid addiction — than pharmacies in more privileged counties.
- In Oregon, a rash of pharmacy closures has created deserts in parts of the state, heightening barriers further, Dan Hartung, co-author of the study and OSU College of Pharmacy professor, told Axios.
- Federal data suggests only slightly more than 1 in 10 people with opioid use disorder receive medication for it.
Driving the news: Starting Sept. 1, the possession of small amounts of illicit drugs will be illegal again in Oregon. Only 28 out of 36 counties have indicated they'll introduce optional deflection programs, which aim to connect drug users with treatment, instead of imposing criminal penalties.
- Yes, but: The state did not issue guidelines for such programs, so access to treatment providers — the first hurdle in accessing medication — will vary on a county-by-county basis based on funding and eligibility.
What they did: After hearing from addiction doctors in Portland, who reported patient difficulty obtaining buprenorphine from pharmacies in the area, researchers deployed a "secret shopper" approach to survey 800 pharmacies across the U.S. to assess availability.
- Researchers posed as patients asking about the pharmacy's capacity to fill a buprenorphine prescription, Hartung said. They focused on counties with higher-than-average overdose rates.
What they found: About 20% of the pharmacies "either did not or would not dispense buprenorphine even if the patient came in with a prescription," Hartung said.
- Further analysis found that counties with the highest levels of racial and economic segregation, based on census data, were two times more likely to restrict access to the drug.
- Independent pharmacies, opposed to chains, were less likely to carry the drug, too.
The bottom line: "Stigma and discrimination against people who use drugs is still pervasive in the healthcare system," Hartung said as to why pharmacies may choose not to carry buprenorphine, despite rising overdose rates caused by synthetic opioids like fentanyl.
- Plus: Since buprenorphine is considered a controlled substance, shipments of it are subject to monitoring by the Drug Enforcement Administration, which some pharmacies are wary of, he added.
What's next: Hartung is currently conducting "education interventions" in Safeway-Albertsons pharmacies in Oregon and Washington, an effort to get pharmacists to prescribe and dispense buprenorphine as well as Narcan, the overdose reversal medication.