Treating Opioid Dependence
with Buprenorphine in the Safety Net:
Critical Learning from Clinical Data
Traci R. Rieckmann, PhD
Nicholas Gideonse, MD
Amanda Risser, MD, MPH
Jennifer E. DeVoe, MD
Amanda J. Abraham, PhD
Research has examined the safety, efﬁcacy, feasibility, and cost-effectiveness of buprenorphine
for the treatment of opioid dependence, but few studies have examined patient and provider
experiences, especially in community health centers. Using de-identiﬁed electronic health record
system (EHRS) data from 70 OCHIN community health centers (n = 1825), this cross-sectional
analysis compared the demographics, comorbidities, and service utilization of patients receiving
buprenorphine to those not receiving medication-assisted treatment (MAT). Compared to non-MAT
patients, buprenorphine patients were younger and less likely to be Hispanic or live in poverty.
Buprenorphine patients were less likely to have Medicaid insurance coverage, more likely to self-
pay, and have private insurance coverage. Buprenorphine patients were less likely to have problem
medical comorbidities or be coprescribed high-risk medications. It is important for providers,
clinic administrators, and patients to understand the clinical application of medications for opioid
dependence to ensure safe and effective care within safety net clinics.
Address correspondence to Traci R. Rieckmann, PhD, OHSU-PSU School of Public Health, Oregon Health & Science
University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. Phone: (503) 494-6739; Email:
Nicholas Gideonse, MD, Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
Amanda Risser, MD, MPH, Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
Jennifer E. DeVoe, MD, OCHIN Community Health Information Network, Portland, OR, USA.
Amanda J. Abraham, PhD, Department of Public Administration and Policy, University of Georgia, Athens, GA, USA.
Some preliminary ﬁndings from this data were presented at the Addiction Health Services Research Conference in New
York on October 18, 2012, in a symposium titled BPrimary Care and Substance Use Disorders: Availability of Services,
Financing and Treatment Options.^
Journal of Behavioral Health Services & Research, 2017. 351–363. c
2017 National Council for Behavioral Health.
Treating Opioid Dependence in the Safety Net RIECKMANN ET AL. 351