Primary Care-Based Models for the Treatment of Opioid Use Disorder: A Scoping Review

Ann Intern Med. 2017 Feb 21;166(4):268-278. doi: 10.7326/M16-2149. Epub 2016 Dec 6.

Abstract

Greater integration of medication-assisted treatment (MAT) for opioid use disorder (OUD) in U.S. primary care settings would expand access to treatment for this condition. Models for integrating MAT into primary care vary in structure. This article summarizes findings of a technical report for the Agency for Healthcare Research and Quality describing MAT models of care for OUD, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings. Common components of existing care models include pharmacotherapy with buprenorphine or naltrexone, provider and community education, coordination and integration of OUD treatment with other medical and psychological needs, and psychosocial services and interventions. Models vary in how each component is implemented. Decisions about adopting MAT models of care should be individualized to address the unique milieu of each implementation setting.

Publication types

  • Review

MeSH terms

  • Buprenorphine / therapeutic use
  • Combined Modality Therapy
  • Education, Medical, Continuing
  • Health Education
  • Humans
  • Naltrexone / therapeutic use
  • Narcotic Antagonists / therapeutic use*
  • Opiate Substitution Treatment*
  • Opioid-Related Disorders / complications
  • Opioid-Related Disorders / drug therapy*
  • Primary Health Care / organization & administration*
  • Psychotherapy

Substances

  • Narcotic Antagonists
  • Buprenorphine
  • Naltrexone