Treating The Opioid Epidemic: Innovations For Expanding Access To Buprenorphine In The United States




Stratton, Elizabeth

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The opioid epidemic in the United States has been a growing problem over the past two decades. There were 2.1 million people in the United States who met the clinical criteria for an opioid use disorder in 2016. Of these people, less than a third of them received evidence based treatment. This thesis focuses on one of the promising forms of treatment for opioid use disorder: medically assisted maintenance (MAT) using buprenorphine. This thesis aimed to answer the following question. How well do the innovative ways for providing medically assisted treatment using buprenorphine address the current barriers to access in the United States? In order to answer this question, the thesis is broken into three parts. The first chapter focuses on the evidence supporting buprenorphine as an effective treatment for opioid use disorder. The second chapter focuses on identifying the current barriers to accessing buprenorphine for MAT in the United States. The third chapter focuses on four innovative methods for providing treatment with buprenorphine: project ECHO, hub and spoke, collaborative care, and hospital initiation of buprenorphine. These innovations were assessed based on their ability to address some of the key barriers to access that were identified in chapter 2 of the thesis.



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