Listings of Buprenorphine Offering by Substance Use Disorder Treatment Facilities and Waivered Clinician From July 2019 to May 2021.

Objectives: This study explores trends in buprenorphine availability at substance use disorder treatment facilities (SUDTFs) and by waivered clinicians during the pandemic. We also examined whether there were differences in access based on a county's metropolitan status and annual fatal drug poisoning rate.

Methods: Data from the Substance Abuse and Mental Health Services Administration' Behavioral Health Treatment Locator between July 2019 and May 2021 were used to calculate trends in SUDTFs offering buprenorphine and the number of waivered clinicians per 10,000 population. We calculated unadjusted trends over time, stratified by whether a county was above or below the annual median age-adjusted fatal drug overdose rate in that year and the county's metropolitan status.

Results: Results showed an increase in SUDTFs and waivered clinicians offering buprenorphine before the pandemic, but the rate leveled off during the pandemic. On average, the increase in facilities was about 8 percentage points per year, and the increase in waivered clinicians was 0.29 per year. The percentage of SUDTFs offering buprenorphine peaked at 47%, and the number of waivered clinicians leveled off at 1.61 per 10,000 population.There were more SUDTFs and clinicians offering buprenorphine in metropolitan versus nonmetropolitan counties. There were also more SUDTFs and clinicians offering buprenorphine in counties above versus below median poisoning rates.

Conclusions: This study provides insights into how buprenorphine availability changed during the COVID-19 pandemic and before the removal of the X-waiver in 2023. More outreach will be needed to encourage the offering of buprenorphine by SUDTFs and office-based clinicians.