Medication Approaches for Patients With Opioid Use Disorders: Differences Between Primary Care Clinics and Specialty...

Area of Science:

• Addiction Medicine
• Health Services Research
• Implementation Science

Background:

• Medications for opioid use disorder (MOUD) are highly effective but access remains limited.
• Primary care settings have been a focus for MOUD expansion, yet specialty addiction treatment programs (SATPs) lag in adoption.
• Understanding medication practices in both primary care and SATPs is crucial for scaling MOUD access.

Purpose of the Study:

• To compare MOUD prescribing practices and implementation capacity between primary care clinics and SATPs.
• To identify differences in organizational support and patient reach for MOUD in diverse care settings.
• To examine community-level factors associated with MOUD adoption in primary care versus specialty addiction treatment.

Main Methods:

• Examined baseline MOUD prescribing data from 62 primary care clinics and SATPs across two states.
• Utilized the Integrating Medications for Addiction Treatment (IMAT) framework to assess MOUD delivery.
• Measured reach, adoption, and organizational support for low-threshold MOUD prescribing, alongside community characteristics.

Main Results:

• SATPs demonstrated lower MOUD capacity and implementation compared to primary care clinics.
• Specialty settings reported less organizational support for low-threshold prescribing.
• SATPs were situated in areas with higher overdose rates, unemployment, and fewer MOUD prescribers.

Conclusions:

• SATPs exhibit lower MOUD implementation capacity and are often in communities with higher OUD-related needs and fewer resources.
• Primary care settings appear to have greater capacity for MOUD implementation.
• Tailored implementation support strategies are essential for SATPs to improve MOUD adoption and address critical treatment gaps.