In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse (\"withdrawal\"), or physicians can keep patients on buprenorphine indefinitely (\"maintenance\"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the physician. Using data from quarterly surveys of physicians from 2006 to 2010, this dissertation analyzes the impact of the higher caseload limit on the number of patients and the treatment path chosen by the physician. It finds support for the conclusion that physicians treat more patients after an increase in the caseload limit. The impact is particularly strong for maintenance, suggesting that the caseload limit discourages maintenance treatment. The dissertation also finds that this effect is stronger for physicians in primary-care type specialties.
","abstract_html":"<p>In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse ("withdrawal"), or physicians can keep patients on buprenorphine indefinitely ("maintenance"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the physician. Using data from quarterly surveys of physicians from 2006 to 2010, this dissertation analyzes the impact of the higher caseload limit on the number of patients and the treatment path chosen by the physician. It finds support for the conclusion that physicians treat more patients after an increase in the caseload limit. The impact is particularly strong for maintenance, suggesting that the caseload limit discourages maintenance treatment. The dissertation also finds that this effect is stronger for physicians in primary-care type specialties.</p>","abstract_has_math":false,"creators":["Fisher, Paul Aaron"],"institution":null,"degree_name":"Ph.D.","degree_level":"Open Access Dissertation","degree_discipline":"Economics","degree_department":null,"school":null,"contributors":["Allen C. Goodman"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2011,"date_issued":"2011-01-01T08:00:00Z","date_published":"2011-01-01T08:00:00Z","updated_at":"2026-07-24T05:58:49Z","subjects":["buprenorphine","opioids","substance abuse","supplier-induced demand","Economics"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.wayne.edu/oa_dissertations/273","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Allen C. Goodman"]},{"key":"dc:creator","label":"Author","values":["Fisher, Paul Aaron"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2011-01-01T08:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Economics"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph.D."]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["buprenorphine","opioids","substance abuse","supplier-induced demand","Economics"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digitalcommons.wayne.edu/oa_dissertations/273"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse (\"withdrawal\"), or physicians can keep patients on buprenorphine indefinitely (\"maintenance\"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the physician. Using data from quarterly surveys of physicians from 2006 to 2010, this dissertation analyzes the impact of the higher caseload limit on the number of patients and the treatment path chosen by the physician. It finds support for the conclusion that physicians treat more patients after an increase in the caseload limit. The impact is particularly strong for maintenance, suggesting that the caseload limit discourages maintenance treatment. The dissertation also finds that this effect is stronger for physicians in primary-care type specialties.
"]},{"key":"dc:title","label":"Title","values":["The impact of regulatory changes on the providers of treatment for opioid dependence"]}]}],"canonical_facts":{"dc:contributor":["Allen C. Goodman"],"dc:creator":["Fisher, Paul Aaron"],"dc:date.available":["2011-01-01T08:00:00Z"],"dc:description.abstract":["In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse (\"withdrawal\"), or physicians can keep patients on buprenorphine indefinitely (\"maintenance\"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the physician. Using data from quarterly surveys of physicians from 2006 to 2010, this dissertation analyzes the impact of the higher caseload limit on the number of patients and the treatment path chosen by the physician. It finds support for the conclusion that physicians treat more patients after an increase in the caseload limit. The impact is particularly strong for maintenance, suggesting that the caseload limit discourages maintenance treatment. The dissertation also finds that this effect is stronger for physicians in primary-care type specialties.
"],"dc:identifier":["https://digitalcommons.wayne.edu/oa_dissertations/273"],"dc:subject":["buprenorphine","opioids","substance abuse","supplier-induced demand","Economics"],"dc:title":["The impact of regulatory changes on the providers of treatment for opioid dependence"],"thesis:degree_discipline":["Economics"],"thesis:degree_level":["Open Access Dissertation"],"thesis:degree_name":["Ph.D."]},"updated_at":"2026-07-24T05:58:49Z"}