Cross-sectional examination of characteristics of higher-dose buprenorphine prescriptions during the era of illicit fentanyl

In 2019-2020, fewer than 3% of dispensed buprenorphine prescriptions exceeded the FDA suggested maximum of 24 mg daily dose; 80% of the prescriptions for a > 24 mg daily dose were written by 4% of buprenorphine prescribers. As clinicians and policymakers pay greater attention to ensuring individuals are receiving buprenorphine dosages adequate to effectively treat their opioid use disorder, the recently revised FDA recommendations may encourage such behavior. Additionally, disproportionate reliance on cash payment for higher daily doses suggests public and private insurers could facilitate access to such treatment when appropriate.