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Treatment of Opioid Dependence in New York State Primary Care Clinics

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Project Summary:

Inadequate capacity of has stimulated efforts to develop primary care practice-based models for the management of opioid dependence. Although primary care-based opioid maintenance (PCOM) has been available for years in other countries, U.S. federal regulations have only recently permitted integrating selected methadone-stabilized patients into primary care practices. However, these initiatives have met with a limited response from primary care providers. To increase the receptiveness of the primary care provider community to PCOM, such initiatives must address specific attitudinal, logistic, and financial barriers expressed by these providers. To explore diverse factors affecting implementation of PCOM, we will conduct qualitative semi-structured interviews followed by quantitative surveys of primary care clinic directors. Our study will be conducted in New York State (NYS) which has the largest number of opioid-dependent persons and methadone maintenance clinics nationally. Our aims are to: •Examine attitudes, facilitators, and barriers to PCOM from 45 qualitative interviews of a stratified random sample of NYS primary care clinic directors; •Develop a structured questionnaire based on the main concepts regarding PCOM identified from the qualitative interviews and administer it to a stratified random sample of 450 NYS primary care clinic directors; •Identify facilitators, barriers, and attitudes affecting willingness to undertake PCOM according to this statewide sample of NYS primary care clinics; •Review our results with an expert panel to identify key findings of relevance to major stakeholders including policymakers, researchers, clinicians, and patients; •Disseminate findings to major stakeholders through meetings, publications, and the University of Pennsylvania website. The study takes advantage of complementary qualitative and quantitative research methodologies to evaluate this poorly understood topic. Our project will also benefit from the input of an expert panel including: federal and state policymakers charged with the oversight of substance abuse treatment; leading researchers in substance abuse; primary care clinicians with expertise in substance abuse; experts in foreign models of PCOM; and clients of a methadone treatment program in NYS. This project will offer benchmark data for policymakers and clinicians to use in future efforts to expand and develop national PCOM capacity.



 
   
 
 
     
   
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