Beliefs and Attitudes about Vermont’s Buprenorphine Decriminalization Law among Clinicians Who Prescribe Buprenorphine

Abstract

Background

On June 1, 2021, Vermont repealed all criminal penalties for possessing 224 milligrams or less of buprenorphine. We examined the potential impact of decriminalization with a survey of Vermont clinicians who prescribed buprenorphine within the past year.

Methods

All 638 Vermont clinicians with a waiver to prescribe buprenorphine were emailed the survey by Vermont Department of Health; 117 responded. We estimated the prevalence of the following four outcomes, for all responding clinicians and stratified by clinician demographics and practice characteristics: awareness of decriminalization, beliefs about the effects of decriminalization, support for decriminalization, and changes in practice resulting from decriminalization.

Results

72 (62%) prescribers correctly stated that Vermont does not have criminal penalties for buprenorphine possession. 107 (91%) support decriminalization. 56 (48%) believe that, because buprenorphine is decriminalized, their patients are more likely to give, sell, or trade the buprenorphine that is prescribed to them to someone else. However, only 5 providers (4%) said they now prescribe to fewer patients.

Conclusion

The great majority of Vermont clinicians who prescribe buprenorphine support its decriminalization and have not changed their prescribing practices because of decriminalization.

Highlights

• In 2021, Vermont repealed criminal penalties for buprenorphine possession.

• We surveyed Vermont (n = 117) buprenorphine prescribers about decriminalization.

• 91% of providers support decriminalization.

• 48% of providers believe decriminalization will increase diversion of medications.

• Only 4% of providers prescribe to fewer patients because of decriminalization.

Keywords:

• Buprenorphine
• drug decriminalization
• overdose
• survey
• state policy

Acknowledgments

We would like to thank Monica Hutt, Chief Prevention Officer for the State of Vermont, and Dr. Mark Levine, MD, for coordinating the development of this report. The data collection and analysis conducted here was overseen and supported by an advisory board of Vermont residents and stakeholders, including Anthony Folland, Peter Espenshade, Dawn Tatro, Anne VanDonsel, Amanda Jones, Xusana Davis, Will Eberle, Jessica King-Mohr, Tucker Jones, and Betty Wheeler. We thank them for their insight and contributions.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by a grant from Bloomberg Philanthropies.