In a recent New England Journal of Medicine article, authors Sarah E. Wakeman, MD, and Michael L. Barnett, MD explain how despite decades of research that has demonstrated the efficacy of medications such as methadone and buprenorphine in improving remission rates and reducing both medical complications and the likelihood of overdose death treatment capacity is still lacking. Nearly 80% of Americans with opioid use disorder don’t receive treatment. Although access to office-based addiction treatment has increased since federal approval of buprenorphine, data from the Drug Enforcement Administration (DEA) reveal that annual growth in buprenorphine distribution has been slowing, rather than accelerating to meet demand (see graph).

To have any hope of stemming the overdose tide, the authors explain that we have to make it easier to obtain buprenorphine than to get heroin and fentanyl. They believe there’s a realistic, scalable solution for reaching the millions of Americans with opioid use disorder: mobilizing the primary care physician (PCP) workforce to offer office-based addiction treatment with buprenorphine, as other countries have done.


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