{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:31:54Z","timestamp":1782552714134,"version":"3.54.5"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Opioid use disorder (OUD) is a cause of significant morbidity and mortality in the United States. Although efforts are being made to limit access to prescription opioids, the use of heroin and synthetic opioids as well as death due to opioid overdose has increased. Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)\u2013approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues. Rural physicians express concern about lack of mentorship and drug diversion as reasons to avoid MAT. The prescribing of MAT with buprenorphine requires a Drug Enforcement Agency (DEA) waiver that can easily be obtained by Family Medicine providers. MAT can be incorporated into the outpatient practice, where patient follow-up rates and number needed to treat to effect change are similar to that of other chronic medical conditions. We describe a case of opioid overdose and a suggested protocol for the induction of MAT with buprenorphine\/naloxone (Suboxone) for OUD in a rural family medicine outpatient practice. Treatment access is facilitated by utilizing the protocol, allowing office staff work to the extent allowed by their licensure, promoting teamwork and minimizing physician time commitment. We conclude that improved access to MAT can be accomplished in a rural family medicine outpatient clinic by staff that support and mentor one another through use of a MAT protocol.<\/jats:p>","DOI":"10.1177\/2150132720931720","type":"journal-article","created":{"date-parts":[[2020,6,6]],"date-time":"2020-06-06T07:12:15Z","timestamp":1591427535000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6446-630X","authenticated-orcid":false,"given":"Mark","family":"Deyo-Svendsen","sequence":"first","affiliation":[{"name":"Mayo Clinic Health System\u2013Northwest Wisconsin, Eau Claire, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Cabrera Svendsen","sequence":"additional","affiliation":[{"name":"Mayo Clinic Health System\u2013Northwest Wisconsin, Eau Claire, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Walker","sequence":"additional","affiliation":[{"name":"Mayo Clinic Health System\u2013Northwest Wisconsin, Eau Claire, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hodges","sequence":"additional","affiliation":[{"name":"Mayo Clinic Health System\u2013Northwest Wisconsin, Eau Claire, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Oldfather","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2351-5640","authenticated-orcid":false,"given":"Meghna P.","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,6]]},"reference":[{"key":"bibr1-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr2-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.10.001"},{"key":"bibr3-2150132720931720","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.131714"},{"key":"bibr4-2150132720931720","unstructured":"Center for Behavioral Health Statistics and Quality. Results from the 2017 National Survey on Drug Use and Health: detailed tables. Published September 7, 2018. Accessed May 18, 2020. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/cbhsq-reports\/NSDUHDetailedTabs2017\/NSDUHDetailedTabs2017.pdf"},{"key":"bibr5-2150132720931720","unstructured":"Centers for Disease Control and Prevention. CDC WONDER. Accessed May 18, 2020. http:\/\/wonder.cdc.gov"},{"key":"bibr6-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2010.09.003"},{"key":"bibr7-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0919"},{"key":"bibr8-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1080\/20961790.2018.1460063"},{"key":"bibr9-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14555"},{"key":"bibr10-2150132720931720","unstructured":"Shah A, Pope J, Lacijan-Drew K. Understanding our members: MAT initiation and engagement through a cascade of care framework. Paper presented at: DATA-Informed Expansion of MAT Services: Process, Framework, and Clinical Transformation; May 29-31, 2019; Bend, OR. Accessed May 18, 2020. https:\/\/www.linesforlife.org\/wp-content\/uploads\/5_30_19-10-am-Cascade-B-Data-Informed-Expansion-of-MAT-Services-Brewster-et-al.pdf"},{"key":"bibr11-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1111\/add.13729"},{"key":"bibr12-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1007\/s11481-018-9801-x"},{"key":"bibr13-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.03.029"},{"key":"bibr14-2150132720931720","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2014.891615"},{"key":"bibr15-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.1205"},{"key":"bibr16-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12307"},{"key":"bibr17-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12328"},{"key":"bibr18-2150132720931720","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2003.10400007"},{"key":"bibr19-2150132720931720","unstructured":"Substance Abuse and Mental Health Services Administration. 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