Why Are Early Career Family Physicians Driving Increases in Buprenorphine Prescribing?

The opioid crisis in the United States has reached epidemic proportions. The most recent data from the National Center for Health Statistics show that overdose deaths continue to increase drastically, from 8050 in 1999 to 70,237 in 2017.1 Medication-assisted treatment with either methadone or buprenorphine has been shown in numerous high-quality trials to decrease mortality, largely due to a significant reduction in fatal overdose.2,3 Despite these clear patient-centered benefits, only 10.6% of patients with opioid use disorder are on medication-assisted treatment.4 Family physicians are solidly positioned to provide this treatment due to their broad scope of care and geographic distribution across the country. Using data from the American Board of Family Medicine, Peterson et al5 show that while buprenorphine prescribing by family physicians increased significantly from 2016 to 2018, that increase was disproportionately driven by early-career physicians with essentially no change in prescribing practices by mid- and late-career family physicians.