Change in opioid and buprenorphine prescribers and prescriptions by specialty, 2016-2021.

BACKGROUND: Safer opioid analgesic prescribing and increasing use of medications for opioid use disorder, including buprenorphine, are strategies prioritized to reduce opioid overdose deaths in the United States. Specialty-specific trends in the number of prescribers and prescriptions for opioid analgesics and buprenorphine are not well characterized.

METHODS: We used data from the IQVIA Longitudinal Prescription database for January 1, 2016 through December 31, 2021. We identified opioid and buprenorphine prescriptions based on NDC codes. We classified prescribers into one of 14 mutually exclusive specialty groups. We calculated the number of prescribers and number of prescriptions for opioids and buprenorphine by specialty and year.

RESULTS: From 2016 to 2021, the total number of opioid analgesic prescriptions dispensed decreased by 32% to 121,693,308 and the number of unique opioid analgesic prescribers decreased 7% to 966,369. Over the same time period, the number of buprenorphine prescriptions dispensed increased 36% to 13,909,724 and unique number of buprenorphine prescribers increased 86% to 59,090. Across most specialties we identified a contraction in the number of opioid prescriptions dispensed and opioid prescribers and an expansion in the number of buprenorphine prescriptions dispensed. Among high-volume opioid prescribing specialties, the largest decrease in opioid prescribers was 32% among Pain Medicine clinicians. By 2021, Advanced Practice Practitioners overtook Primary Care clinicians as the highest volume buprenorphine prescribers.

CONCLUSIONS: More work is needed to understand the impact of clinicians who stop prescribing opioids. While the trend in buprenorphine prescribing is encouraging, further expansion is warranted to meet the underlying need.