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News
Pharmacy dispensing of buprenorphine, a key treatment for opioid use disorder, peaked in 2021 and has been declining ever since — even as opioid deaths remain staggeringly high. A new CDC-backed report in MMWR finds that rural areas saw the steepest drop, despite historically higher dispensing rates. Meanwhile, ED-based buprenorphine use is growing but still far too low to fill the gap.
Pharmacy dispensing of buprenorphine — one of the most effective treatments for opioid use disorder (OUD) — climbed from 2019 to 2021, then reversed course, falling steadily through 2025, according to new data published in the Morbidity and Mortality Weekly Report. With 54,045 opioid-related deaths in 2024 and an estimated 4.8 million Americans living with OUD, researchers say the drug remains critically underused. Rural counties, which had seen faster growth in dispensing early on (partly fueled by COVID-era telehealth flexibilities), experienced the sharpest declines — a troubling sign given their limited access to specialty OUD care.
On a brighter note, emergency departments are stepping up: buprenorphine adoption in EDs rose from 6.7% to 31.4% in urban counties and from 2.3% to 10.3% in rural counties between 2019 and 2025. Researchers credit growing awareness, peer support programs, and clinical decision tools — but stress that overall ED adoption is still too low, representing "missed opportunities" for treatment.
By the Numbers:
Why it matters: Buprenorphine is proven to reduce opioid deaths, but access gaps — especially in rural America — are widening. Expanding ED-based initiation and telehealth prescribing could be game-changers, but systemic barriers like staffing shortages and limited behavioral health infrastructure still stand in the way.