What Are Best Practices for Providing Buprenorphine Maintenance Treatment in Rural Primary Care?

Research center:
Lead researcher:
Project funded:
September 2017
Project completed:
August 2018

The prevalence of Opioid Use Disorder (OUD) is increasing at an alarming rate in the U.S., and access to treatment continues to be a challenge for rural patients. Although the number of physicians with a Drug Enforcement Agency (DEA) waiver to prescribe buprenorphine, an effective treatment, has increased significantly, a large percentage of these physicians report using their waiver very little or not at all. More than half of all rural counties (60%) in the U.S. lack a physician with a waiver to prescribe buprenorphine, and more than half of physicians (53%) with the initial waiver to prescribe buprenorphine to treat Opioid Use Disorder report they are not currently treating any patients. Many rural physicians have reported barriers to adding buprenorphine treatment to their practices, but many have overcome these difficulties and are successfully treating patients. Learning about best practices to educate and support other potential prescribers and expand access to treatment was the focus of this project. We used data from a recent WWAMI Rural Health Research Center survey of rural physicians with a DEA waiver to prescribe buprenorphine to identify physicians who are successfully prescribing buprenorphine for OUD. We conducted interviews with a sample of physicians who have successfully added buprenorphine treatment to their practice to understand how physicians have mitigated or overcome commonly cited barriers to incorporating buprenorphine treatment into practice.