Buprenorphine prescriptions at community health centers (CHCs), a medication-assisted treatment (MAT) considered the gold standard for opioid use disorder (OUD), are rising significantly nationwide. Recent research published by JAMA highlights this encouraging trend, emphasizing how increased Buprenorphine prescriptions community health centers are expanding access to evidence-based treatment and helping to combat the devastating opioid epidemic.
Between 2016 and 2021, the percentage of patients receiving buprenorphine at CHCs increased from just 0.5% to 1.4%. In parallel, the percentage of clinicians prescribing buprenorphine rose sharply from 8.9% to 37.5% during this period. These findings come from a comprehensive analysis of electronic health records from 166 clinics within the OCHIN network, a nonprofit health IT organization focused on community-based care, encompassing data from 2,186 unique clinicians.
Significant Increases Across Clinician Types and Settings
The study showed that the greatest increases in prescribing were among nurse practitioners (NPs) and physician assistants (PAs), particularly in urban community health centers. Despite this, physicians remain the most likely to prescribe buprenorphine, especially in rural settings — where nearly half of physicians were prescribing the medication by 2021. Researchers observed that increases in buprenorphine prescribing were similar in both urban and rural clinics, suggesting that access to medication treatment for OUD is improving broadly across geographic lines.
This data is especially important considering the ongoing toll of the opioid crisis. According to the Centers for Disease Control and Prevention (CDC), more than 75% of drug overdose deaths in 2021 involved opioids. Increasing access to effective treatments like buprenorphine is critical to reversing this trend and saving lives.
The Role of Policy Changes in Expanding Buprenorphine Access
A major factor driving the rise in buprenorphine prescriptions is federal policy reform, particularly the elimination of the Drug Enforcement Administration’s (DEA) X-waiver in 2023. Prior to this change, clinicians needed an X-waiver to prescribe buprenorphine, which involved additional training requirements and administrative hurdles. These barriers severely limited the number of providers who could offer this lifesaving treatment.
Before the X-waiver was removed, only a small fraction of clinicians nationwide held this authorization: approximately 6% of physicians, 9% of nurse practitioners, and 5% of physician assistants. The removal of this requirement has dramatically expanded the pool of clinicians who can prescribe buprenorphine, helping to close treatment gaps.
In fact, the study shows that within the OCHIN network, over one-third of clinicians now prescribe buprenorphine — a figure that substantially exceeds prior national estimates. This trend signals a major shift in how addiction treatment is integrated into primary care settings, particularly those serving vulnerable and underserved populations. The surge in buprenorphine prescriptions community health centers represents a hopeful sign that these reforms are reaching the front lines.
Overcoming Stigma and Reluctance in Prescribing MAT
Despite these positive trends, many primary care providers remain hesitant to prescribe buprenorphine. Industry experts have pointed out that removing the X-waiver is not a “silver bullet” solution that will instantly expand treatment capacity on its own.
Steve Priest, CEO and founder of Spero Health — an addiction treatment organization operating 99 outpatient healthcare locations — explained in an interview with Behavioral Health Business that eliminating the X-waiver primarily reduces stigma and removes bureaucratic constraints that have historically discouraged providers from specializing in addiction medicine.
“This is not some practical and tactical thing that, like magic, is going to increase the number of people in treatment by 400%,” Priest said. “I think it provides the opportunity for a physician or nurse practitioner to have a real practice [in addiction medicine] and to not be restrained. To put it bluntly, getting rid of the X-waiver helps reduce stigma in the medical community.”
Reducing stigma is critical to encouraging more providers to integrate MAT into their practice and to normalize addiction treatment as a core part of healthcare rather than a separate specialty burdened by regulations. This shift is a key factor contributing to the rise of buprenorphine prescriptions community health centers nationwide.
The Critical Role of Community Health Centers in Addressing OUD
Community health centers are uniquely positioned to improve access to MAT for populations who often face multiple barriers to care, including low-income individuals, racial and ethnic minorities, and rural residents. These centers typically provide integrated, comprehensive care and serve as safety-net providers, making their increased adoption of buprenorphine prescribing a vital step in combating the opioid epidemic.
The JAMA study’s findings demonstrate that more clinicians at CHCs are embracing buprenorphine prescribing, bringing evidence-based OUD treatment closer to patients who need it most. By integrating MAT into primary care workflows, CHCs are helping to dismantle longstanding gaps in treatment access and creating more entry points for people seeking recovery. The continuing growth in buprenorphine prescriptions community health centers highlights the critical role these facilities play in expanding life-saving treatment.
Looking Ahead: Opportunities and Challenges
While the upward trend in buprenorphine prescribing at community health centers is encouraging, challenges remain. Many providers still lack training or confidence to treat OUD, and systemic barriers such as insufficient reimbursement, limited behavioral health integration, and persistent stigma continue to impede broader adoption.
Ongoing efforts are needed to support clinicians through education, peer mentoring, and practice resources that build their competence and comfort with addiction treatment. Expanding interdisciplinary care teams that include behavioral health specialists and peer support workers can also improve patient outcomes.
As federal and state policies continue to evolve, the momentum to expand MAT access must be matched by investments in workforce development and infrastructure. Doing so will ensure that more people struggling with opioid use disorder receive timely, effective care — helping to drive further increases in buprenorphine prescriptions community health centers nationwide.
Conclusion
The increase in buprenorphine prescriptions and prescribers at community health centers marks a significant step forward in addressing the opioid crisis. Thanks to federal policy changes like the elimination of the X-waiver and growing acceptance of MAT within primary care, more patients have access to lifesaving treatment than ever before.
Community health centers, with their reach into underserved communities, are at the forefront of this transformation. However, continued efforts to reduce stigma, educate providers, and strengthen care integration are essential to fully realize the potential of buprenorphine and other MAT options in saving lives and supporting recovery.
The ongoing rise in buprenorphine prescriptions community health centers offers hope that treatment is becoming more accessible, equitable, and integrated across the healthcare system.
