Buprenorphine dispensing among youth aged ≤19 Years in the United States: 2015–2020

Investigators from the CDC, Atlanta, GA, conducted a retrospective study to describe current prescribing patterns of buprenorphine for treatment of opioid use disorder (OUD) in US youths and evaluate trends over the period 2015–2020. For the study, they reviewed IQVIA National Prescription Audit to Brand and Total Patient data, which contains prescription information from 48,900 retail pharmacies in the US, representing 92% of all prescriptions in the US. Data on prescriptions of buprenorphine to youths ≤19 years old between 2015 and 2020 were abstracted. It was assumed that all buprenorphine prescriptions were for treatment of OUD. From the information collected, the total number of prescriptions to youths, total number of youths with at least 1 buprenorphine prescription each year, and number of prescriptions to youths 12-17 and 18-19 years old, were determined. US census data were used to estimate rates. Data on prescriptions to males and female also were collected, as well as provider type. Changes in prescribing rates between 2015 and 20120 were calculated. For comparison, rates of buprenorphine prescribing to adults ≥20 years old also were determined.

From 2015 to 2020, 347,905 prescriptions for buprenorphine were dispensed in the US to youths ≤19 years old. The average annual number of prescriptions was 57,984, or 0.71 prescriptions per 1,000 US youths. Between 2015 and 2020 the rate of buprenorphine decreased 25% (0.84 to 0.63 prescriptions per 1,000 persons). Pediatricians accounted for 1.0% to 2.1% of all buprenorphine prescriptions each year, and prescribing by pediatricians fell by 39% during the study period. Between 2015 and 2018, family physicians and psychiatrists were the leading prescribers of buprenorphine, accounting for 18% to 21% and 14% to 18% of all prescriptions annually, respectively. However, by 2020, nurse practitioners were the leading prescribers (26.6%). Buprenorphine was prescribed to 22,393 youths from 2015 to 2020, for an annual rate of 5.1 per 100,000 youths. Although the overall annual rates of prescribing to males and females were similar (5.2 and 5.0 per 100,000 persons, respectively), prescription rates decreased 54% for females between 2015 and 2020 compared to a decrease of 38% in males. Among youths, 87% of buprenorphine prescriptions were for those 18 to 19 years old. The annual number of 18–19-year-old youths who had at least 1 prescription for buprenorphine was 3,612, compared to 375 adolescents 12-17 years old. During the study period, the annual rate of adults prescribed buprenorphine was 465.5 per 100,000.

The authors conclude that buprenorphine dispensing to US youth is low and decreasing.

Dr Doolittle has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

The results of the current study highlight an important gap in the care of teenagers with OUD. As many as 0.5% of adolescents have OUD,...

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