Monday, July 1, 2024

Many People Still Unaware That Primary Care Physicians Can Prescribe OUD Medications

Most patients do not know they can receive medication treatment for opioid use disorder (OUD) from their primary care physician, a research letter in JAMA Network Open has found.

Brandon del Pozo, Ph.D., M.P.A., M.A., of Brown University and colleagues examined data from 1,234 individuals who responded to a survey for the Justice Community Opioid Innovation Network in 2023.

Among all respondents, 61.4% did not know a primary care physician could treat people with OUD by prescribing medication, and 13.3% incorrectly believed a primary care physician could not prescribe OUD medication. The researchers identified both age and racial/ethnic differences in the responses; compared with White respondents, for example, respondents of other races were more likely to believe they could not receive medication for OUD from a primary care physician. Most respondents agreed (52.8%) or strongly agreed (24.2%) that a primary care physician’s office should be a place where people can receive OUD treatment.

Among respondents who reported misusing prescription or illicit opioids, 50.6% said they would be very comfortable and 30.7% said they would be somewhat comfortable personally seeking medications for OUD from their primary care physician. Of the respondents with no history of opioid misuse, 31.9% said they would be very comfortable and 42.0% said they would be somewhat comfortable referring someone they cared about to their primary care physician for medications for OUD.

Raising awareness that primary care physicians can provide medications like buprenorphine is critical to increasing effective treatment of OUD and reducing the race-and-ethnicity–based disparities observed in this study, the researchers wrote. They suggested the following:

  • Messaging campaigns similar to those for HIV testing and cancer screening.
  • Literature and signage in waiting areas and examination rooms at primary care offices.
  • Proactive screening of patients for OUD by primary care physicians and offering medications for OUD when indicated.

In a viewpoint in JAMA, M. Allison Arwady, M.D., M.P.H., of the National Center for Injury Prevention and Control and colleagues noted a study in Morbidity and Mortality Weekly Report that found that of all individuals who needed treatment for OUD, only 55.2% received any treatment and only 25.1% received medication for OUD. They wrote that some health care professionals may be hesitant to prescribe OUD to patients who perceive a need for treatment or may continue to encourage only detoxification.

Arwady and colleagues offered five suggestions for all health care professionals to improve the cascade of care for patients with OUD as follows:

  • Routinely screen for OUD, diagnose OUD, and educate patients about OUD.
  • Routinely discuss medication options (methadone, buprenorphine, or naltrexone) with patients with OUD while connecting patients to available recovery support services.
  • Prescribe buprenorphine themselves.
  • Continue shared decision-making practices with patients around treatment initiation and retention.
  • Share and reinforce harm reduction strategies with all patients with OUD, regardless of whether the patient is ready for treatment or not.

For related information, see the Psychiatric News Special Report “Opioid Use Disorder—Treatment in an Ever-Changing Crisis.”

(Image: Getty Images/iStock/Hailshadow)

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