Research Update
A Mixed-method Comparison of Physician-reported Beliefs About and Barriers to Treatment with Medications for Opioid Use Disorder
This project was recently published in the Journal of Substance Abuse Treatment, Prevention, and Policy.
Project Background
Despite evidence illustrating medications for treating opioid use disorder (MOUD)—namely buprenorphine, methadone, and extended-release naltrexone—are effective at treating the disorder and reducing associated harms, there remains a distinct underutilization of MOUD. This lack of usage stems largely from an under-supply of trained providers, particularly those willing to prescribe MOUD.

This study looks to understand comparative beliefs about MOUD and barriers to usage of MOUD with a mixed-methods approach involving focus group interviews and an online physician survey. Focus group results were thematically analyzed, with survey results using descriptive and inferential statistical methods.
Physicians self-reported higher perceptions of efficacy for methadone and buprenorphine than for extended-release naltrexone, citing insurance obstacles as the most frequent barrier to prescribing MOUD. Regulatory barriers were also mentioned, though they were not considered as significant barriers by many physicians in office-based settings.

Focus group responses indicated that financial, logistical, and workforce barriers were obstacles to prescribing MOUD, and mentioned a lack of addiction treatment specialists as a strong factor in workforce barriers.

As such, the study identified the need for increased physician education regarding the comparative efficacy between different MOUD. In addition, policies should mandate full insurance coverage of MOUD and prohibit prior authorization requirements in order to reduce some of the physician-reported barriers.
Rebecca Haffajee, J.D., PhD, MPH
Barbara Andraka-Christou, Ph.D., J.D., B.A.
Angela J. Beck, PhD, MPH

Jeremy Attermann, LGSW, CAPM
Anna Cupito, MPH
Jessica Buche, MPH, MA
This publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $900,000. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit
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