{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T02:05:37Z","timestamp":1783044337266,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T00:00:00Z","timestamp":1539907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["U1CRH03712"],"award-info":[{"award-number":["U1CRH03712"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The United States is in the midst of a severe opioid use disorder epidemic. Buprenorphine is an effective office\u2010based treatment that can be prescribed by physicians, nurse practitioners, and physician assistants with a Drug Enforcement Administration (DEA) waiver. However, many providers report barriers that keep them from either getting a DEA waiver or fully using it. The study team interviewed rural physicians successfully prescribing buprenorphine to identify strategies for overcoming commonly cited barriers for providing this service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Interview candidates were randomly selected from a list of rurally located physicians with a DEA waiver to prescribe buprenorphine who reported treating high numbers of patients on a 2016 survey. Forty\u2010three rural physicians, who were prescribing buprenorphine to a high number of patients, were interviewed about how they overcame prescribing barriers previously identified in that survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Interviewed physicians reported numerous ways to overcome common barriers to providing buprenorphine treatment in rural areas. Key recommendations included ways to (1) get started and maintain medication\u2010assisted treatment, (2) minimize DEA intrusion and medication diversion, and (3) address the lack of mental health providers and stigma surrounding opioid use disorder (OUD). Overall, physicians found providing this service to be very rewarding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite known barriers, rural physicians around the country have been successful in adding buprenorphine treatment to their practices. Nonprescribing providers can learn from the strategies used by successful prescribers to add this service.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12328","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T17:03:26Z","timestamp":1539968606000},"page":"113-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians"],"prefix":"10.1111","volume":"35","author":[{"given":"C. Holly A.","family":"Andrilla","sequence":"first","affiliation":[{"name":"WWAMI Rural Health Research Center, Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa E.","family":"Moore","sequence":"additional","affiliation":[{"name":"WWAMI Rural Health Research Center, Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis G.","family":"Patterson","sequence":"additional","affiliation":[{"name":"WWAMI Rural Health Research Center, Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,19]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Center for Behavioral Health Statistics and Quality.Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health(HHS Publication No. SMA 16\u20134984 NSDUH Series H\u201051). Available at:https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUH-FFR1-2015\/NSDUH-FFR1-2015\/NSDUH-FFR1-2015.pdf. Published September2016. Accessed April 25 2018."},{"key":"e_1_2_6_3_1","volume-title":"Drug overdose deaths in the United States, 1999\u20132016. NCHS Data Brief #294","author":"Hedegaard H","year":"2017"},{"key":"e_1_2_6_4_1","unstructured":"American Society of Addiction Medicine.FAQs About the Final Rule Raising the Buprenorphine Patient Limit. Available at:https:\/\/www.asam.org\/docs\/default-source\/advocacy\/faq-on-how-to-navigate-the-final-rule.pdf?sfvrsn=9af77c2_0. Accessed May 15 2018."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300256"},{"key":"e_1_2_6_6_1","unstructured":"Substance Abuse and Mental Health Services Administration.Methadone. Available at:https:\/\/www.samhsa.gov\/medication-assisted-treatment\/treatment\/methadone. Published September 28 2015. 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Accessed October 20 2017."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_6_16_1","unstructured":"Drug Enforcement Administration.DEA Requirements for DATA Waived Physicians (DWPs). Available at:https:\/\/www.deadiversion.usdoj.gov\/pubs\/docs\/dwp_buprenorphine.htm. Accessed May 15 2018."},{"key":"e_1_2_6_17_1","unstructured":"Substance Abuse and Mental Health Services Administration.Buprenorphine Waiver Management. Available at:https:\/\/www.samhsa.gov\/programs-campaigns\/medication-assisted-treatment\/training-materials-resources\/buprenorphine-waiver. Published January 18 2018. Accessed May 15 2018."},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0881-9"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2014.955469"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0022776"},{"key":"e_1_2_6_21_1","unstructured":"Drug Enforcement Administration.Drug Enforcement Administration (DEA) Registration File Monthly. Available at:https:\/\/deanumber.com\/RelId\/609513\/ISvars\/default\/CD_ROM_Single_Issue.htm. Published December2017. Accessed January 18 2018."},{"key":"e_1_2_6_22_1","author":"US Department of Health and Human Services","year":"2018","journal-title":"Area Health Resource Files"},{"key":"e_1_2_6_23_1","unstructured":"American Medical Association.Physician Masterfile. Published2016. Accessed October 20 2017."}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjrh.12328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T04:11:49Z","timestamp":1694751109000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.12328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,19]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/jrh.12328"],"URL":"https:\/\/doi.org\/10.1111\/jrh.12328","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"value":"0890-765X","type":"print"},{"value":"1748-0361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,19]]},"assertion":[{"value":"2018-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}