Clinic-based treatment for opioid dependence: A qualitative inquiry

Objectives: To identify barriers and facilitators to treatment of opioid dependence in primary care clinics. Methods: In depth interviews with 27 New York State clinic directors. Results: Stigmatising attitudes emerged as a major barrier. Respondents often viewed opioid-dependent persons as manipulative, demanding, and disruptive. Commonly cited facilitators were physician training, increased office staffing, and greater mental health, social services, and addictions support. Conclusions: Our study reveals attitudinal barriers to address and supportive factors to promote in order to increase the limited availability of office-based treatment of opioid dependence in the United States compared with other countries.