Barriers and facilitators to medications for Opioid Use prescribing in primary care in the United States: a scoping review

Background: Medication for opioid use disorder (MOUD) has been proven to reduce the ill effects of opioid use disorder yet remains under prescribed, especially in primary care settings. This scoping review sought to identify barriers and facilitators to providing MOUD in US primary care settings. Methods: We conducted a scoping review of academic literature published between 1 January 2006 and 31 December 2023, following PRISMA extension guidelines. Results: Of 681 articles initially identified, 23 met our inclusion criteria. The three primary barriers to MOUD practice identified in this review were: (1) logistical and institutional challenges, (2) lack of knowledge and training, and (3) stigma and fear of diversion. Facilitators were less frequently discussed in the selected manuscripts; they included: (1) education and training, and (2) improved reimbursement and clinical policies and protocols. Discussion: Findings indicate a need to improve providers' perceptions of MOUD and to change the culture of primary care treatment offices. Strategies for improving healthcare leaders' prioritization and support for MOUD delivery, additional resources to address time constraints associated with delivering MOUD, and streamlining credentialing and privileging processes may be necessary to increase MOUD prescribing in primary care settings.