(471) How many DATA-waivered providers in California actively prescribe buprenorphine: a geospatial analysis

Objective : Qualified clinicians must obtain a practitioner waiver (i.e., “DATA-waiver”) to offer buprenorphine, a medication for opioid use disorder (MOUD). However, many counties face obstacles in implementing the prescription of these medications, such as lacking providers or underutilizing MOUD prescriptions through “X-waiver” providers. California invests heavily to provide better access to OUD treatment. Our study aimed to compare the availability of active buprenorphine-prescribing clinicians in California to the Substance Abuse and Mental Health Services Administration (SAMSHA) -listed DATA waived prescribers under each 5-digit ZIP Code.

Methods: This is a retrospective study utilizing the buprenorphine prescription record data in 2021 from California’s Controlled Substance Utilization Review and Evaluation System (CURES). The list of the locators for all X-waiver clinicians was obtained from the SAMHSA webpage. Descriptive analysis was conducted to illustrate the distribution of ZIP Codes with DATA-waived clinicians and active prescribers based on patient volumes. The bivariate choropleth maps denoted the spatial relationship of DATA waived clinicians, active buprenorphine prescribers, and patient volume under each ZIP code.

Results: Data from 8,013 active buprenorphine-prescribing clinicians and 6,699 DATA-waived physicians were analyzed. Among 1,600 ZIP Codes where patients resided, 62.1% housed DATA-waived physicians, and 57.8% had active buprenorphine-prescribing clinicians. Prescribers were generally well-distributed concerning patient volumes, but disproportional distribution between buprenorphine-prescribing clinicians and DATA-waived physicians was evident.

Conclusions: California demonstrates proficiency in aligning the distribution of active prescribers with patient demand, yet it also grapples with disparities in the availability of DATA-waived clinicians and active-prescribing physicians. Resolving these challenges calls for resource allocation and collaboration across professions. The policy amendments outlined in the 2022 Omnibus bill offer potential solutions, highlighting the need for ongoing research to evaluate their effectiveness.