How can communities address the barriers for potential outpatient buprenorphine prescribers in order to encourage them to treat patients with opioid use disorder?

Nearly half the physicians waivered to prescribe Buprenorphine are prescribing it. Barriers include induction logistics, poor compliance and limited counseling opportunities. The Collaborative Opioid Prescribing (“CoOP”) model was designed to address these needs and support these physicians in order to encourage them to treat opioid use disorder and prescribe Buprenorphine. In the model, the Opioid Treatment Program (OTP) serves as a hub, providing comprehensive substance use disorder evaluations, Buprenorphine inductions and counseling services, including management of complicated situations such as poor/partial response (adherence, tox screen) requiring treatment plan changes (switching to methadone, referral to higher level of care, etc.), addressing previously untreated addiction, and providing ready access to expertise for outpatient buprenorphine prescribers. Once stabilized, patients can be transferred to outpatient buprenorphine prescribers for continued management and treatment of their opioid use disorder.

For more information, see this article: Brooner, R.K., et al. (2004). Behavioral contingencies improve counseling attendance in an adaptive treatment model. J Subst Abuse Treat 27, 223-232.

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