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Opioid-involved overdose deaths continue to climb, in part because of suboptimal access to and retention on medications for opioid use disorder (MOUD), including buprenorphine. “Low barrier” buprenorphine treatment aims to reduce or eliminate the threshold for getting and staying on medication by providing immediate and long-term access to buprenorphine without strict rules or requirements. This study examines associations between medical providers’ beliefs about people with opioid use disorder (OUD) and naloxone access with their self-reported “low-barrier” buprenorphine prescribing practices. We surveyed providers (N=123) who completed X-waiver courses in Missouri between March 2017 and September 2019. The survey included questions about buprenorphine prescribing behaviors as well as the Naloxone-Related Risk Compensation Beliefs (NaRCC-B) scale and Attitudes toward Patients with OUD scale. Analyses consisted of a series of linear and logistic regressions with the NaRCC-B and OUD Attitudes scales predicting various domains of “low-threshold” prescribing behaviors (such as length of buprenorphine treatment and requirements for drug testing). Findings indicate medical providers’ beliefs about people with OUD are associated with their practice of addiction medicine, with individuals with more favorable views being more likely to endorse “low-threshold” buprenorphine prescribing practices than those with less favorable views. Providers’ beliefs about naloxone being enabling were less related to their buprenorphine practices but strongly related to their likelihood of providing naloxone. Though findings are correlational and not causal, these associations suggest future prescriber trainings aiming to increase positive interactions with and attitudes toward people with OUD, as well as encouragement of flexible and “low barrier” buprenorphine prescribing practices, may help increase patients’ access to and retention on maintenance buprenorphine. |
