Primary care providers have increasingly offered patients medications for opioid use disorder (MOUD) since the Drug Addiction Treatment Act (DATA) of 2000 allowed certain physicians outside of the psychiatry field to prescribe these medications.
Low-barrier access to MOUDs, including naltrexone and buprenorphine, can play a meaningful role in combating the opioid use epidemic, which resulted in almost 82,000 deaths in 2022, according to the National Institute on Drug Abuse.
But most people either do not know that primary care physicians can prescribe MOUDs or incorrectly believe that these physicians cannot prescribe these medications, a new study funded by the National Institutes of Health (NIH) and published in JAMA Network Open found.
“The findings suggest most respondents did not know a [primary care physician] (PCP) can provide MOUD,” the study’s authors wrote. “Raising awareness that PCPs can is critical to increasing effective treatment of OUD and reducing the race-and ethnicity-based disparities in knowledge about MOUD access observed in this study.”
MOUDs sharply decrease the risk of death for patients with opioid use disorder and are “incredibly safe” for long-term use. However, these medications are significantly underutilized, in part because of stigma and lack of knowledge.
The study used data collected from a June 2023 survey for the Justice Community Opioid Innovation Network.
Demographic data collected in the survey revealed race and ethnicity-based disparities. More Black and white respondents knew that primary care physicians could prescribe MOUDs than Hispanic or Latino respondents. Additionally, almost 20% of both Black and Hispanic or Latino respondents incorrectly stated that primary care providers could not prescribe MOUDs.
Increasing awareness is critical to address these disparities in knowledge and to increase MOUD prescriptions, the authors wrote.
The authors recommend various interventions to increase awareness, including messaging campaigns similar to those used for HIV testing and cancer screening.
Federal agencies have launched several HIV/AIDS campaigns to, among other aims, increase awareness of treatment and reduce stigma, two factors that have historically hindered efforts to combat the opioid epidemic.
The study’s authors also suggest that primary care doctors proactively screen patients and offer to prescribe MOUDs when needed. Experts have recommended increased screenings for SUDs in other health care sites, including emergency departments.
But additional screenings and demand for MOUDs may require additional clinical and administrative support, the authors note, including access to addiction medicine consultations.
Previous research suggests other interventions, including workload reductions, protected time and clinical resources could incentivize primary care providers to prescribe MOUDs.
These recommendations could address barriers to primary care providers prescribing MOUDs identified in previous studies. These barriers include a lack of administrative support and negative attitudes toward MOUDs, as well as anticipation of an unmanageable flood of patients seeking medication.