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A majority of US adults (61%) are unaware that primary care physicians (PCPs) can prescribe medications for opioid use disorder (MOUD), and 13% incorrectly believe that they could not, according to data from a national survey funded by the National Institutes of Health (NIH).¹

Findings from the survey of over 1200 Americans also showed that Black respondents were more likely to believe they could not receive MOUD via a PCP compared to other demographic groups.¹

“Raising awareness that PCPs can [provide MOUD] is critical to increasing effective treatment of [opioid use disorder] and reducing the race-and-ethnicity-based disparities in knowledge about MOUD access observed in this study,” lead author Brandon del Pozo, PhD, assistant professor, Warren Alpert Medical School of Brown University, Brown University School of Public Health, and colleagues wrote in JAMA Network Open. “Interventions could include messaging campaigns similar to those for HIV testing and cancer screening.”¹

PCPs can be an effective resource in expanding access to buprenorphine, the only office-based MOUD that has shown to be effective in reducing overdose mortality, according to del Pozo and coauthors. To help expand buprenorphine-based treatment in primary care clinics, federal policy has removed specialized training requirements for prescribing physicians and lifted patient caps. “A wide gap remains, however, between buprenorphine need and provision in primary care settings,” investigators wrote.¹

To better understand this gap in research, researchers designed survey questions on patient awareness of and comfort around seeking MOUD from PCPs. These questions were added to a June 2023 survey conducted in English and Spanish by the Justice Community Opioid Innovation Network. The survey was offered online and by telephone to a nationally representative sample of adults 18 years and older.¹

Findings

A total of 1234 individuals (56.5% women) responded to the survey, of whom 11.5% were Black, 15.2% were Hispanic or Latino, 68.4% White, 4.8% as other or with 2 or more races.¹

Results from a weighted analysis showed that 61.4% of respondents were unaware that a PCP could prescribe MOUD and 13.3% incorrectly believed a PCP could not. Most respondents agreed (53.9%) or strongly agreed (24.9%) that a PCP office should offer MOUD, according to investigators.¹

Among 266 respondents with any history of opioid misuse, 50.6% stated they would be very comfortable and 30.7% said they would be somewhat comfortable personally seeking MOUD from their PCP. Moreover, of the 945 participants with no history of opioid misuse, 31.9% said they would be very comfortable and 42.0% would be somewhat comfortable referring a loved one to their PCP for MOUD.¹

In aggregate, Black respondents (20.9% weighted) were most likely to believe they could not receive MOUD through their PCP, according to investigators.¹

“We’ve made great strides in making it easier for primary care doctors to prescribe these safe and effective treatments, but our study indicates a critical disconnect between the need for medications for opioid use disorder and people’s knowledge about how to access them,” del Pozo said in an NIH press release. “Science, public health, insurance, policy, and public perception all must align to improve access to treatment.”²

Along with messaging campaigns similar to those of HIV and cancer screening, interventions to increase awareness include placing literature and signage about MOUD in waiting areas and examination rooms, proactively screening patients for OUD, and offering to prescribe MOUD as needed. These measures “may increase demand and incentive PCPs to offer MOUD, especially if accompanied by clinical and administrative support, such as access to addiction medicine consultations,” del Pozo and colleagues concluded.¹

References:

1. Del Pozo B, Park JN, Taylor BG, et al. Knowledge, attitudes, and beliefs about opioid use disorder treatment in primary care. JAMA Netw Open. Published online June 28, 2024. doi:10.1001/jamanetworkopen.2024.19094
2. Most Americans don’t know that primary care physicians can prescribe addiction treatment. News item. National Institutes of Health. June 28, 2024. Accessed July 3, 2024. https://www.nih.gov/news-events/news-releases/most-americans-don-t-know-primary-care-physicians-can-prescribe-addiction-treatment