title: Trends in the use of buprenorphine by office-based physicians in the United States, 2003-2013.
abstract: OBJECTIVE
  Despite buprenorphine's promise as a novel therapy for opioid dependence, little is known about its clinical adoption. We characterized trends in ambulatory use of buprenorphine in the United States.
  
  
  METHODS
  Cross-sectional, descriptive analyses of buprenorphine utilization from 2003 to 2013 using the IMS Health National Disease and Therapeutic Index, a nationally representative audit of ambulatory care. The primary unit of analysis was an office visit where buprenorphine was used for opioid dependence (treatment visit).
  
  
  RESULTS
  Between 2003 and 2013, there was significant uptake of buprenorphine in ambulatory treatment visits, from 0.16 million [M] (95% confidence interval [CI] 0.10-0.20) visits in 2003 to 2.1M (CI 1.9-2.3M) treatment visits during 2013. Approximately 90% involved the use of brand name combination buprenorphine/naloxone (Suboxone), although this percentage decreased modestly to 80% by the last quarter of 2013. Buprenorphine prescribing increased among all specialties, but the proportion accounted for by primary care physicians increased significantly from 6.0% in 2003 to 63.5% in 2013 and decreased among psychiatrists from 92.2% to 32.8% over the same time period.
  
  
  CONCLUSIONS
  The use of buprenorphine products to treat opioid dependence has increased significantly in the past 10 years and has shifted to greater use by primary care physicians, indicating a rapidly changing face of opioid maintenance therapy in the United States.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Lydia
authors.initials: L
authors.lastname: Turner
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Kruszewski
authors.forename: G Caleb
authors.initials: GC
authors.lastname: Alexander
mesh_terms: D000553:Ambulatory Care / Q000639:trends*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use*; D000069479:Buprenorphine, Naloxone Drug Combination / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006801:Humans; D009293:Opioid-Related Disorders / Q000188:drug therapy; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D000069479:Buprenorphine, Naloxone Drug Combination; D002047:Buprenorphine