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: Stigmatizing 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.