The Role of Low-Threshold Treatment for Patients with OUD in Primary Care 

Purpose

Care of patients with opioid use disorder (OUD) is a natural fit for primary care and its fundamental strengths: respect for the patient, long-term clinical relationships, non-stigmatizing support, a degree of comfort with uncertainty, and a focus on whole-person care. 

All that is missing is a prescription for buprenorphine.

But we know things are not that simple. In 2017, fewer than 10 percent of primary care clinicians prescribed buprenorphine for OUD. Many studies have examined the barriers clinicians face in providing treatment for patients with OUD. Clinicians frequently cite logistical issues, including lack of time and support from staff, concerns about insurance reimbursement, need for prior authorizations, and regulatory factors, as common barriers to providing care for patients with OUD. One regulatory barrier, obtaining an X waiver to prescribe buprenorphine for patients with OUD, has been legally removed as of December 2022. (Agency for Healthcare Research and Quality, USA, 2023)

https://integrationacademy.ahrq.gov/products/topic-briefs/oud-low-threshold-treatment