Evidence map›Paper›PMID 35101112›Full record

ArticleAddiction science & clinical practice2022

Rural and urban differences in undersupply of buprenorphine provider availability in the United States, 2018.

Kevin P Conway, Dalia Khoury, Rainer Hilscher, Arnie P Aldridge, Stephanie J Parker, Gary A Zarkin

Abstract read
In one paragraph

Article in Addiction science & clinical practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Primary care professionals' perspectives on tailoring buprenorphine training for rural practice.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kevin P ConwayNational Institute of Mental Health, Bethesda, MD, USA.
Dalia KhouryResearch Triangle Institute International, Research Triangle Park, NC, USA. dkhoury@rti.org.ORCID 0000-0002-9055-2022
Rainer HilscherResearch Triangle Institute International, Research Triangle Park, NC, USA.
Arnie P AldridgeResearch Triangle Institute International, Research Triangle Park, NC, USA.
Stephanie J ParkerResearch Triangle Institute International, Research Triangle Park, NC, USA.
Gary A ZarkinResearch Triangle Institute International, Research Triangle Park, NC, USA.

Funding

Population-Based Epidemiologic ResearchZIAMH002953 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI MERIKANGAS, KATHLEEN R · 2016 to 2025
$7.0M
Intramural NIH HHS ZIA MH002953
6 · The paper itself

Abstract

backgroundMedications to treat opioid use disorder (OUD) including buprenorphine products are evidence-based and cost-effective tools for combating the opioid crisis. However, limited availability to buprenorphine is pervasive in the United States (US) and may serve to exacerbate the deadly epidemic. Although prior research points to rural counties as especially needy of strategies that improve buprenorphine availability, it is important to investigate the availability of waivered providers according to treatment need as defined by the county-level rate of opioid-overdose deaths (OOD). This study examined differences in buprenorphine provider availability relative to treatment need among rural and urban counties in the US.

methodsBuprenorphine provider availability relative to need in each county was defined as the number of waivered providers divided by the rate of OODs (i.e., number of OODs/100,000 population), according to 2018 data. Counties with ratios in the bottom tertile of their state were classified as buprenorphine undersupplied. We estimated logit models to statistically test the association of rurality and state main effects and their interaction terms (independent variables) and the county classified as buprenorphine undersupplied (dependent variable).

resultsA total of 38 states and 2595 counties had sufficient non-suppressed data to remain in the analysis. A larger percent of urban counties (36.43%) than rural counties (32.01%) were classified as buprenorphine undersupplied (p  = 0.001). The likelihood of a rural county being undersupplied varied considerably by state (Chi Square  = 82.88, p  = 0.000). All states with significant (p  < 0.05 or p  < 0.10) interaction terms showed lower likelihood of buprenorphine undersupply in rural counties.

conclusionsThe rural-urban distribution in undersupply of waivered buprenorphine providers relative to need varied markedly by state. Strategies for improving access to buprenorphine-waivered providers should be state-centric and informed by county-specific indicators of need.

Indexed as

BuprenorphineOpioid-Related DisordersHumansRural PopulationUnited StatesBuprenorphineBuprenorphineMedication for opioid use disorderOpioidsTreatment access

Identifiers

PMID35101112
PMCPMC8802270

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.