Primary Care Doctors Can Prescribe Addiction Treatment

Results from a national survey indicate that 61% of Americans are unaware that primary care physicians can prescribe medications for opioid use disorder, and 13% incorrectly believed that they could not. The survey, funded by the National Institutes of Health (NIH), also found that 82% of the people who reported ever misusing prescription or illicit opioids expressed comfort in going to their primary care physicians for medications for opioid use disorder. Among those who had not misused opioids, a majority, 74%, reported they would be comfortable referring their loved ones to primary care for these medications.

Notably, Black American respondents were most likely to incorrectly believe they could not receive medications for opioid use disorder via primary care, pointing to an important disparity in information that may further impede access to treatment. The findings suggest there is an important opportunity to increase awareness of these treatments and how to access them – using efforts that employ culturally specific strategies to reach different groups. Decades of research have shown the overwhelming benefit of existing medications for opioid use disorder, such as buprenorphine and methadone.

Recent federal policy changes have removed some barriers to prescribing buprenorphine by primary care physicians, such as specialized training requirements (elimination of the X-waiver in 2023) and patient caps. Despite these changes, there remain barriers to receiving medication for opioid use disorder. A recent study found that, in the year after elimination of the waiver requirement to prescribe buprenorphine, the number of prescribers increased, but the number of persons who received the medication did not.

Studies estimate that fewer than 2,500 physicians specialize in addiction medicine in the U.S. With approximately 209,000 primary care physicians in the U.S., channeling addiction treatment through primary care could have a significant public health impact.

Researchers at Brown University, Providence, Rhode Island studied public health factors that may impede access to these medications. They surveyed people’s awareness of and comfort around opioid use disorder treatment in primary care. In collaboration with the National Institute on Drug Abuse (NIDA), the researchers added these questions to a survey conducted in English and Spanish by the Justice Community Opioid Innovation Network (JCOIN) and administered this survey in June 2023, targeting a nationally representative sample of adults aged 18 and older.

Among 1,234 respondents, 57% were female, 43% were male, 12% were Black, 15% were Hispanic/Latino, 68% were white, and 5% reported other or two or more races. Most respondents agreed (53%) or strongly agreed (24%) that the office of a primary care physician should be a place where people can receive treatment for an opioid use disorder.

Researchers maintain that future research should explore targeted strategies to enhance public awareness and investigate the impact of increased primary care physicians’ involvement in providing medications for opioid use disorder. Awareness campaigns akin to those for HIV testing and cancer screening – including educational materials in medical settings and proactive screening by primary care physicians – may help address this gap in public knowledge. By increasing public awareness and demand, primary care physicians may be more incentivized to offer medications for opioid use disorder, especially with appropriate clinical and administrative support, the authors say.

Substance use disorders are chronic, treatable conditions from which people can recover. In 2022, nearly 49 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention and education agency in the City of Glen Cove. Its Coalition is conducting an opioid prevention awareness campaign entitled, "Keeping Glen Cove SAFE," to educate and update the community regarding prescription and illicit drug use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovec... or visit SAFE’s website to learn more about prescription drug use and the Opioid Epidemic at www.safeglencove.org.