About 1 in 4 Pharmacies Dispense Buprenorphine, But Disparities Persist
In pharmacies in predominantly Black and Latino neighborhoods, only 18% and 17% were likely to carry buprenorphine compared with white neighborhoods.
Approximately 39% of pharmacies in the US dispensed buprenorphine in 2023, which is a 6% increase from 2017, according to an article published in Health Affairs. Buprenorphine is the only scheduled medication for opioid use disorder that can be prescribed at both the primary care and pharmacy levels in the US. Although it did increase, investigators found persistent disparities for who can access treatment. In pharmacies in predominantly Black and Latino neighborhoods, only 18% and 17% were likely to carry buprenorphine compared with 46% in predominantly white neighborhoods.1,2
In pharmacies in predominantly Black and Latino neighborhoods, only 18% and 17% were likely to carry buprenorphine compared with white neighborhoods. | Image Credit: Ming - stock.adobe.com
“Relaxing buprenorphine prescribing rules was an important step in making this critical treatment more accessible, but too many patients lack a nearby pharmacy that carries it,” Dima Mazen Qato, senior scholar at the Schaeffer Center and the Hygeia Centennial Chair at the USC Mann School of Pharmacy and Pharmaceutical Sciences, said in a news release.2 “Federal and state policymakers must reduce barriers that make it difficult for pharmacies to stock buprenorphine, especially in some of the more vulnerable communities.”
Even with most states increasing buprenorphine availability, Florida, Ohio, Tennessee, Washington, Virginia, and Washington DC all had significant declines. In California, Illinois, and Pennsylvania, the availability in Black or Latino neighborhoods was about 4 to 5 times lower than in white neighborhoods. Additionally, investigators noted that independent pharmacies in Black and Latino neighborhoods were significantly less likely to have buprenorphine and more likely to stop carrying it over time. Furthermore, independent pharmacies were more likely to fill approximately twice as many prescriptions per month compared with any other type of pharmacy.1
“If policymakers fail to introduce policies that increase equitable access to buprenorphine at local pharmacies, existing racial and ethnic disparities in opioid use disorder treatment and recovery will likely worsen,” Jenny S. Guadamuz, an assistant professor at the University of California, Berkeley School of Public Health, said in the news release.2
In addition to buprenorphine, methadone treatment is also an option to treat opioid use disorder, and although it seems to be accepted by patients, significant barriers remain. In fact, patients who received pharmacy-based methadone treatment embraced the model despite the restrictive practices in place for opioid treatment programs (OTP), according to results of a study published in Health Affairs.3
In order to enable pharmacy-based methadone treatment programs, community pharmacies must partner with OTPs that create medication units to dispense the drug. However, these are rarely implemented because the approval process and regulatory requirements are very complex. Furthermore, pharmacies can also face state legislative challenges as well as reimbursement barriers. Changes to federal law and regulations can also allow physicians to prescribe the drug and community pharmacies to dispense it.3
There were 31 people included in this study, with 3 patients who were in long-term recovery and experienced access to methadone, 5 patients in early recovery using either methadone or buprenorphine, 5 OTP leaders, 7 pharmacy leaders, 6 payers, and 5 policy makers. Investigators found that people from all groups said reducing stigma and increasing privacy are important for the outcomes of these programs. Further, participants stated that decentralizing methadone services through pharmacies could allow more access to patients and reduce exposure to open-air drug markets, making it safer. However, the current laws and regulations are restrictive for access, according to the study authors.3
“Results identified potential advantages to pharmacy-based methadone, including the geographic convenience of pharmacies and that care delivered at the pharmacy may be an overall more patient-centered experience than that delivered at an OTP,” the study authors said.3 “The most salient disadvantages related to pharmacy-based methadone generally were concerns about diversion and increasing overdose deaths and the lack of comprehensive medical and social services available at pharmacies.”
READ MORE: Mental and Behavioral Health Resource Center
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REFERENCES
1. Guadamuz JS, Axeen S, Qato DM. Trends In The Availability Of Buprenorphine At US Retail Pharmacies, 2017-23. Health Aff (Millwood). 2025;44(9):1157-1163. doi:10.1377/hlthaff.2025.00349
2. Despite relaxed prescribing rules, opioid addiction treatment still hard to find at pharmacies. News release. University of South Carolina. September 2, 2025. Accessed September 3, 2025. https://www.eurekalert.org/news-releases/1096113
3. Stewart MT, Feltus SR, Tschampl CA, Bratberg JP, Green TC. Key-Informant Perspectives On Pharmacy-Based Methadone Treatment For Opioid Use Disorder In The US. Health Aff (Millwood). 2025;44(9):1164-1172. doi:10.1377/hlthaff.2025.00344
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