Physicians’ Barriers to Incorporating Buprenorphine Maintenance Treatment Into Clinical Practice, by Prescribing Category
| Barrier | Overall | Never a Prescriber | Former Prescribera | Current Prescriber Not Accepting New Patientsb | Current Prescriber Accepting New Patientsc | P Valued |
|---|---|---|---|---|---|---|
| No. | 1,124 | 124 | 197 | 129 | 674 | |
| Time constraints, % | 40.2 | 45.6 | 52.1 | 43.5 | 35.8 | .008 |
| Lack of patient need, % | 2.4 | 9.3 | 4.3 | 1.9 | 1.3 | .003e |
| Financial/reimbursement concerns, % | 28.6 | 18.9 | 31.6 | 17.0 | 31.6 | .007 |
| Resistance from practice partner, % | 13.6 | 21.8 | 30.2 | 8.8 | 9.6 | <.001 |
| Lack of specialty backup for complex problems, % | 31.5 | 40.0 | 45.3 | 34.9 | 26.3 | <.001 |
| Lack of confidence in ability to manage opioid use disorder, % | 9.6 | 38.2 | 11.2 | 9.4 | 5.8 | <.001 |
| Lack of available mental health or psychosocial support services, % | 44.4 | 48.1 | 50.4 | 49.1 | 41.4 | .192 |
| Attraction of drug users to your practice, % | 30.5 | 38.5 | 51.7 | 35.2 | 23.3 | <.001 |
| DEA intrusion, % | 13.8 | 18.5 | 19.1 | 14.2 | 11.9 | .158 |
| Diversion or misuse of medication concerns, % | 48.4 | 42.6 | 53.0 | 55.8 | 46.3 | .185 |
DEA=Drug Enforcement Administration.
Note: Missing data: time, n = 373; patient need, n = 379; financial, n = 380; resistance, n = 391; specialty backup, n = 379; confidence, n = 381; available mental health services, n = 376; attraction of drug users, n = 384; DEA intrusion, n = 386; diversion, n = 477.
↵a Have prescribed buprenorphine, but not currently treating patients or accepting new opioid use disorder patients.
↵b Have prescribed buprenorphine, currently treating patients, but not accepting new opioid use disorder patients (may or may not have reached the patient limit of their waiver).
↵c Currently treating patients and accepting new opioid use disorder patients.
↵d Overall 4-category χ2 test.
↵e Fisher exact test.