{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:37:53Z","timestamp":1769107073803,"version":"3.49.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["F31DA057107"],"award-info":[{"award-number":["F31DA057107"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA052975"],"award-info":[{"award-number":["R01DA052975"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["P50DA05407"],"award-info":[{"award-number":["P50DA05407"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Addict Sci Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>How communities impact patients taking medication for opioid use disorder (MOUD) has not been well-studied. Understanding the experience of MOUD providers allows us to better understand and measure community attitudes toward MOUD and identify strategies to increase support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We deployed an explanatory sequential mixed methods design to analyze baseline data from the SITT-MAT clinical trial. Our quantitative instrument was seven Likert-scale questions asking about community attitudes toward MOUD analyzed through means, standard deviations, and principal components. The qualitative data were semi-structured interviews coded inductively using a thematic analysis. The quantitative and qualitative results were integrated to produce the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We surveyed staff from 20 specialty care addiction and primary care clinics in Washington state as part of a larger clinical trial. Eleven sites were also selected to complete an interview. Participating clinics were primarily specialty addiction treatment programs (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200914, 70%), outpatient (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200917, 85%), and\/or located in urban areas (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200912, 81%). In the survey, participants most agreed that relationships with other clinics help provide better care and least agreed that system-level policies mandate MOUD. In interviews, some staff described how reliable relationships with other clinics improved employee morale and patient care while others added that loose collaborations had fallen apart, leaving patients without the care they need. Interviewees described how insurer and government policies have made it difficult to expand their MOUD offerings. The interview data also indicated community attitudes on MOUD have improved over time with some clinics using direct outreach to garner support for MOUD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that building local peer networks of clinics can improve staff morale and patient care in areas where community support for MOUD is low. Though system-level barriers to MOUD have been reduced, there is still room for improvement in simplifying reimbursements and funding for clinics looking to improve care. Our findings encourage further measurement of community attitudes toward MOUD and development of implementation strategies to build networks that support patients and clinics alike.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The data for this study is from the Stagewise Implementation-to-Target \u2013 Medications for Addiction Treatment clinical trial registered as NCT05343793 on April 25, 2022.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13722-025-00643-1","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T16:15:10Z","timestamp":1767888910000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A mixed methods analysis of clinics\u2019 perspectives on community factors influencing access to medications for opioid use disorder"],"prefix":"10.1186","volume":"21","author":[{"given":"Samuel","family":"Jaros","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam Abdel","family":"Magid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Gassman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne Chokron","family":"Garneau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James H.","family":"Ford II","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"McGovern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"643_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/S0140-6736(21)02252-2","volume":"399","author":"K Humphreys","year":"2022","unstructured":"Humphreys K, Shover CL, Andrews CM, Bohnert ASB, Brandeau ML, Caulkins JP, et al. Responding to the opioid crisis in North America and beyond: recommendations of the Stanford\u2013Lancet commission. Lancet. 2022;399:555\u2013604. https:\/\/doi.org\/10.1016\/S0140-6736(21)02252-2.","journal-title":"Lancet"},{"key":"643_CR2","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1097\/ADM.0000000000000314","volume":"11","author":"SE Wakeman","year":"2017","unstructured":"Wakeman SE, Kanter GP, Donelan K. Institutional substance use disorder intervention improves general internist preparedness, attitudes, and clinical practice. J Addict Med. 2017;11:308. https:\/\/doi.org\/10.1097\/ADM.0000000000000314.","journal-title":"J Addict Med"},{"key":"643_CR3","doi-asserted-by":"publisher","first-page":"100029","DOI":"10.1016\/j.rcsop.2021.100029","volume":"2","author":"A Cernasev","year":"2021","unstructured":"Cernasev A, Hohmeier KC, Frederick K, Jasmin H, Gatwood J. A systematic literature review of patient perspectives of barriers and facilitators to access, adherence, stigma, and persistence to treatment for substance use disorder. Explor Res Clin Soc Pharm. 2021;2:100029. https:\/\/doi.org\/10.1016\/j.rcsop.2021.100029.","journal-title":"Explor Res Clin Soc Pharm"},{"key":"643_CR4","doi-asserted-by":"publisher","first-page":"108146","DOI":"10.1016\/j.jsat.2020.108146","volume":"119","author":"K Cioe","year":"2020","unstructured":"Cioe K, Biondi BE, Easly R, Simard A, Zheng X, Springer SA. A systematic review of patients\u2019 and providers\u2019 perspectives of medications for treatment of opioid use disorder. J Subst Abuse Treat. 2020;119:108146. https:\/\/doi.org\/10.1016\/j.jsat.2020.108146.","journal-title":"J Subst Abuse Treat"},{"key":"643_CR5","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1080\/10826084.2021.1975749","volume":"56","author":"EF Madden","year":"2021","unstructured":"Madden EF, Prevedel S, Light T, Sulzer SH. Intervention stigma toward medications for opioid use disorder: a systematic review. Subst Use Misuse. 2021;56:2181\u2013201. https:\/\/doi.org\/10.1080\/10826084.2021.1975749.","journal-title":"Subst Use Misuse"},{"key":"643_CR6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12916-019-1256-2","volume":"17","author":"L Nyblade","year":"2019","unstructured":"Nyblade L, Stockton MA, Giger K, Bond V, Ekstrand ML, Lean RM, et al. Stigma in health facilities: why it matters and how we can change it. BMC Med. 2019;17:25. https:\/\/doi.org\/10.1186\/s12916-019-1256-2.","journal-title":"BMC Med"},{"key":"643_CR7","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13012-023-01302-2","volume":"18","author":"R Lengnick-Hall","year":"2023","unstructured":"Lengnick-Hall R, Williams NJ, Ehrhart MG, Willging CE, Bunger AC, Beidas RS, et al. Eight characteristics of rigorous multilevel implementation research: a step-by-step guide. Implement Sci. 2023;18:52. https:\/\/doi.org\/10.1186\/s13012-023-01302-2.","journal-title":"Implement Sci"},{"key":"643_CR8","doi-asserted-by":"publisher","unstructured":"Shafiee SA, Razaghi E, Vedadhir AA. Multi-level approach to theories of addiction: a critical review. Iran J Psychiatry Behav Sci. 2019;13. https:\/\/doi.org\/10.5812\/ijpbs.88881.","DOI":"10.5812\/ijpbs.88881"},{"key":"643_CR9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s13011-020-00288-0","volume":"15","author":"J Zwick","year":"2020","unstructured":"Zwick J, Appleseth H, Arndt S. Stigma: how it affects the substance use disorder patient. Subst Abuse Treat Prev Policy. 2020;15:50. https:\/\/doi.org\/10.1186\/s13011-020-00288-0.","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"643_CR10","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1097\/PHH.0000000000001995","volume":"30","author":"KD Smith","year":"2024","unstructured":"Smith KD, Peyson RL. Eradicating substance use stigma through community power. J Public Health Manage Pract. 2024;30:649. https:\/\/doi.org\/10.1097\/PHH.0000000000001995.","journal-title":"J Public Health Manage Pract"},{"key":"643_CR11","doi-asserted-by":"publisher","first-page":"15065","DOI":"10.3390\/ijerph192215065","volume":"19","author":"V Bright","year":"2022","unstructured":"Bright V, Riddle J, Kerver J. Stigma experienced by rural pregnant women with substance use disorder: a scoping review and qualitative synthesis. Int J Environ Res Public Health. 2022;19:15065. https:\/\/doi.org\/10.3390\/ijerph192215065.","journal-title":"Int J Environ Res Public Health"},{"key":"643_CR12","doi-asserted-by":"publisher","first-page":"e0235150","DOI":"10.1371\/journal.pone.0235150","volume":"15","author":"M Cai","year":"2020","unstructured":"Cai M, Shah N, Li J, Chen W-H, Cuomo RE, Obradovich N, et al. Identification and characterization of tweets related to the 2015 Indiana HIV outbreak: a retrospective infoveillance study. PLoS ONE. 2020;15:e0235150. https:\/\/doi.org\/10.1371\/journal.pone.0235150.","journal-title":"PLoS ONE"},{"key":"643_CR13","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.apnu.2023.09.001","volume":"46","author":"SL Cody","year":"2023","unstructured":"Cody SL, Newman S, Bui C, Sharp-Marbury R, Scott L. Substance use and opioid-related stigma among black communities in the rural South. Arch Psychiatr Nurs. 2023;46:127\u201332. https:\/\/doi.org\/10.1016\/j.apnu.2023.09.001.","journal-title":"Arch Psychiatr Nurs"},{"key":"643_CR14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/jrh.12503","volume":"37","author":"T Beachler","year":"2021","unstructured":"Beachler T, Zeller TA, Heo M, Lanzillotta-Rangeley J, Litwin AH. Community attitudes toward opioid use disorder and medication for opioid use disorder in a rural Appalachian County. J Rural Health. 2021;37:29\u201334. https:\/\/doi.org\/10.1111\/jrh.12503.","journal-title":"J Rural Health"},{"key":"643_CR15","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1080\/10550887.2021.1979837","volume":"40","author":"TA Zeller","year":"2022","unstructured":"Zeller TA, Beachler T, Diaz L, Thomas RP, Heo M, Lanzillotta-Rangeley J, et al. Attitudes toward syringe exchange programs in a rural Appalachian community. J Addict Dis. 2022;40:227\u201334. https:\/\/doi.org\/10.1080\/10550887.2021.1979837.","journal-title":"J Addict Dis"},{"key":"643_CR16","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1007\/s11121-021-01329-1","volume":"23","author":"A Solovei","year":"2022","unstructured":"Solovei A, Jan\u00e9-Llopis E, Mercken L, Bustamante I, Kokole D, Mej\u00eda-Trujillo J, et al. Effect of community support on the implementation of primary health care-based measurement of alcohol consumption. Prev Sci. 2022;23:224\u201336. https:\/\/doi.org\/10.1007\/s11121-021-01329-1.","journal-title":"Prev Sci"},{"key":"643_CR17","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1080\/07448481.2020.1807992","volume":"70","author":"B Doughty","year":"2022","unstructured":"Doughty B, Young S, Eggleston W. Assessment of a comprehensive Naloxone education program\u2019s impact on community member knowledge and attitudes on a college campus. J Am Coll Health. 2022;70:1332\u20135. https:\/\/doi.org\/10.1080\/07448481.2020.1807992.","journal-title":"J Am Coll Health"},{"key":"643_CR18","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1176\/appi.ps.201500049","volume":"67","author":"EH Flanagan","year":"2016","unstructured":"Flanagan EH, Buck T, Gamble A, Hunter C, Sewell I, Davidson L. Recovery speaks: a photovoice intervention to reduce stigma among primary care providers. PS. 2016;67:566\u20139. https:\/\/doi.org\/10.1176\/appi.ps.201500049.","journal-title":"PS"},{"key":"643_CR19","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s10461-021-03363-0","volume":"26","author":"L Li","year":"2022","unstructured":"Li L, Lin C, Liang L-J, Nguyen DB, Pham LQ, Le TA, et al. Community capacity Building for HIV and addiction service integration: an intervention trial in Vietnam. AIDS Behav. 2022;26:123\u201331. https:\/\/doi.org\/10.1007\/s10461-021-03363-0.","journal-title":"AIDS Behav"},{"key":"643_CR20","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s13012-022-01239-y","volume":"17","author":"JH Ford","year":"2022","unstructured":"Ford JH, Cheng H, Gassman M, Fontaine H, Garneau HC, Keith R, et al. Stepped implementation-to-target: a study protocol of an adaptive trial to expand access to addiction medications. Implement Sci. 2022;17:64. https:\/\/doi.org\/10.1186\/s13012-022-01239-y.","journal-title":"Implement Sci"},{"key":"643_CR21","unstructured":"Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. SAGE Publications, Inc.; 2017."},{"key":"643_CR22","unstructured":"Chokron Garneau H, Cheng H, Kim J, Abdel Magid M, Chin-Purcell L, McGovern MP. Pragmatic measure of context at the organizational level: the inventory of factors affecting successful implementation and sustainment (IFASIS). Implementation Science Communications n.d."},{"key":"643_CR23","doi-asserted-by":"publisher","first-page":"108395","DOI":"10.1016\/j.jsat.2021.108395","volume":"126","author":"H Chokron Garneau","year":"2021","unstructured":"Chokron Garneau H, Hurley B, Fisher T, Newman S, Copeland M, Caton L, et al. The integrating medications for addiction treatment (IMAT) index: a measure of capability at the organizational level. J Subst Abuse Treat. 2021;126:108395. https:\/\/doi.org\/10.1016\/j.jsat.2021.108395.","journal-title":"J Subst Abuse Treat"},{"key":"643_CR24","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s43058-025-00708-x","volume":"6","author":"A Jakubowski","year":"2025","unstructured":"Jakubowski A, Patrick B, DiClemente-Bosco K, Salino S, Scott K, Becker S. Using the IFASIS (Inventory of factors affecting successful implementation and Sustainment) to advance context-specific and generalizable knowledge of implementation determinants: case study of a digital contingency management platform. Implement Sci Commun. 2025;6:35. https:\/\/doi.org\/10.1186\/s43058-025-00708-x.","journal-title":"Implement Sci Commun"},{"key":"643_CR25","doi-asserted-by":"publisher","first-page":"311","DOI":"10.24874\/PES02.03.010","volume":"2","author":"SN Chakrabartty","year":"2020","unstructured":"Chakrabartty SN. Combining likert items with different number of response categories. PES. 2020;2:311\u201322. https:\/\/doi.org\/10.24874\/PES02.03.010.","journal-title":"PES"},{"key":"643_CR26","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1002\/wics.101","volume":"2","author":"H Abdi","year":"2010","unstructured":"Abdi H, Williams LJ. Principal component analysis. WIRE Comput Stat. 2010;2:433\u201359. https:\/\/doi.org\/10.1002\/wics.101.","journal-title":"WIRE Comput Stat"},{"key":"643_CR27","unstructured":"R Core Team. R: A language and environment for statistical computing 2024."},{"key":"643_CR28","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/BF00988249","volume":"9","author":"JE Trost","year":"1986","unstructured":"Trost JE. Statistically nonrepresentative stratified sampling: a sampling technique for qualitative studies. Qual Sociol. 1986;9:54\u20137. https:\/\/doi.org\/10.1007\/BF00988249.","journal-title":"Qual Sociol"},{"key":"643_CR29","doi-asserted-by":"publisher","first-page":"100198","DOI":"10.1016\/j.glmedi.2025.100198","volume":"6","author":"SK Ahmed","year":"2025","unstructured":"Ahmed SK, Mohammed RA, Nashwan AJ, Ibrahim RH, Abdalla AQ, Ameen M. Using thematic analysis in qualitative research. J Med Surg Public Health. 2025;6:100198. https:\/\/doi.org\/10.1016\/j.glmedi.2025.100198.","journal-title":"J Med Surg Public Health"},{"key":"643_CR30","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12874-019-0707-y","volume":"19","author":"K Roberts","year":"2019","unstructured":"Roberts K, Dowell A, Nie J-B. Attempting rigour and replicability in thematic analysis of qualitative research data; a case study of codebook development. BMC Med Res Methodol. 2019;19:66. https:\/\/doi.org\/10.1186\/s12874-019-0707-y.","journal-title":"BMC Med Res Methodol"},{"key":"643_CR31","doi-asserted-by":"publisher","unstructured":"Franklin C, Ballan M. Reliability and validity in qualitative research. The handbook of social work research methods. SAGE Publications, Inc.; 2001. https:\/\/doi.org\/10.4135\/9781412986182.","DOI":"10.4135\/9781412986182"},{"key":"643_CR32","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.1111\/1475-6773.12117","volume":"48","author":"MD Fetters","year":"2013","unstructured":"Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs\u2014principles and practices. Health Serv Res. 2013;48:2134\u201356. https:\/\/doi.org\/10.1111\/1475-6773.12117.","journal-title":"Health Serv Res"},{"key":"643_CR33","unstructured":"Dedoose. version 9.0.90, cloud application for managing, analyzing, and presenting qualitative and mixed method research data 2023."},{"key":"643_CR34","unstructured":"Davis J. The X-waiver is gone\u2026 but there is a lot more work to do to increase access to opioid use disorder treatment. American College of Emergency Physicians 2023. https:\/\/www.acep.org\/federal-advocacy\/federal-advocacy-overview\/regs--eggs\/regs--eggs-articles\/regs--eggs---march-23-2023 (accessed November 25, 2024)."},{"key":"643_CR35","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1215\/03616878-8970796","volume":"46","author":"RG Frank","year":"2021","unstructured":"Frank RG, Humphreys KN, Pollack HA. Policy responses to the addiction crisis. J Health Polit Policy Law. 2021;46:585\u201397. https:\/\/doi.org\/10.1215\/03616878-8970796.","journal-title":"J Health Polit Policy Law"},{"key":"643_CR36","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1007\/s11606-020-06266-3","volume":"35","author":"KC Priest","year":"2020","unstructured":"Priest KC, McCarty D, Lovejoy TI. Expanding access to medications for opioid use disorder: program and policy approaches from outside the veterans health administration. J Gen Intern Med. 2020;35:886\u201390. https:\/\/doi.org\/10.1007\/s11606-020-06266-3.","journal-title":"J Gen Intern Med"},{"key":"643_CR37","unstructured":"Robinson L. Rolfes, Mullet, Dhingra. SB 5536-2023-34. 2023."},{"key":"643_CR38","unstructured":"Gordon BcCloud S. State of Washington v. Shannon B. Blake; 2021."},{"key":"643_CR39","doi-asserted-by":"publisher","first-page":"6950","DOI":"10.3390\/ijerph20206950","volume":"20","author":"BR Brady","year":"2023","unstructured":"Brady BR, Taj EA, Cameron E, Yoder AM, De La Rosa JS. A diagram of the social-ecological conditions of opioid misuse and overdose. Int J Environ Res Public Health. 2023;20:6950. https:\/\/doi.org\/10.3390\/ijerph20206950.","journal-title":"Int J Environ Res Public Health"},{"key":"643_CR40","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12954-022-00684-8","volume":"19","author":"ST Allen","year":"2022","unstructured":"Allen ST, Danforth S, Grieb SM, Glick JL, Harris SJ, Tomko C, et al. Law enforcement and syringe services program implementation in rural counties in kentucky: a qualitative exploration. Harm Reduct J. 2022;19:109. https:\/\/doi.org\/10.1186\/s12954-022-00684-8.","journal-title":"Harm Reduct J"},{"key":"643_CR41","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.addbeh.2018.02.024","volume":"86","author":"L Brinkley-Rubinstein","year":"2018","unstructured":"Brinkley-Rubinstein L, Zaller N, Martino S, Cloud DH, McCauley E, Heise A, et al. Criminal justice continuum for opioid users at risk of overdose. Addict Behav. 2018;86:104\u201310. https:\/\/doi.org\/10.1016\/j.addbeh.2018.02.024.","journal-title":"Addict Behav"},{"key":"643_CR42","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1097\/JAN.0000000000000456","volume":"33","author":"CH Dahlem","year":"2022","unstructured":"Dahlem CH, Granner J, Boyd CJ. Law enforcement perceptions about Naloxone training and its effects post-overdose reversal. J Addictions Nurs. 2022;33:80. https:\/\/doi.org\/10.1097\/JAN.0000000000000456.","journal-title":"J Addictions Nurs"},{"key":"643_CR43","doi-asserted-by":"publisher","first-page":"109254","DOI":"10.1016\/j.drugalcdep.2021.109254","volume":"231","author":"EA Evans","year":"2022","unstructured":"Evans EA, Wilson D, Friedmann PD. Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder. Drug Alcohol Depend. 2022;231:109254. https:\/\/doi.org\/10.1016\/j.drugalcdep.2021.109254.","journal-title":"Drug Alcohol Depend"},{"key":"643_CR44","doi-asserted-by":"publisher","unstructured":"Pozo B del. CommunityStat: a public health intervention to reduce opioid overdose deaths in Burlington, Vermont, 2017\u20132020. Contemp Drug Probl. 2021;49(3). https:\/\/doi.org\/10.1177\/00914509211052107.","DOI":"10.1177\/00914509211052107"},{"key":"643_CR45","doi-asserted-by":"publisher","first-page":"117822182110397","DOI":"10.1177\/11782218211039781","volume":"15","author":"B Green","year":"2021","unstructured":"Green B, Rhubart DC, Filteau MR. Barriers for implementing the hub and spoke model to expand medication for opioid use disorder: a case study of Montana. Subst Abuse. 2021;15:11782218211039781. https:\/\/doi.org\/10.1177\/11782218211039781.","journal-title":"Subst Abuse"},{"key":"643_CR46","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1080\/13561820.2019.1636007","volume":"34","author":"E Schot","year":"2020","unstructured":"Schot E, Tummers L, Noordegraaf M. Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. J Interprof Care. 2020;34:332\u201342. https:\/\/doi.org\/10.1080\/13561820.2019.1636007.","journal-title":"J Interprof Care"},{"key":"643_CR47","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1080\/08897077.2020.1846149","volume":"42","author":"C Snell-Rood","year":"2021","unstructured":"Snell-Rood C, Willging C, Showalter D, Peters H, Pollini RA. System-level factors shaping the implementation of hub and spoke systems to expand MOUD in rural areas. Substance Abuse. 2021;42:716\u201325. https:\/\/doi.org\/10.1080\/08897077.2020.1846149.","journal-title":"Substance Abuse"},{"key":"643_CR48","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.jsat.2015.06.010","volume":"60","author":"CT LaBelle","year":"2016","unstructured":"LaBelle CT, Han SC, Bergeron A, Samet JH. Office-Based opioid treatment with buprenorphine (OBOT-B): statewide implementation of the Massachusetts collaborative care model in community health centers. J Subst Abuse Treat. 2016;60:6\u201313. https:\/\/doi.org\/10.1016\/j.jsat.2015.06.010.","journal-title":"J Subst Abuse Treat"},{"key":"643_CR49","doi-asserted-by":"publisher","first-page":"153","DOI":"10.2147\/JHL.S396659","volume":"15","author":"S Rabin","year":"2023","unstructured":"Rabin S, Kika N, Lamb D, Murphy D, Stevelink AM, Williamson S. Moral injuries in healthcare workers: what causes them and what to do about them? J Healthc Leadersh. 2023;15:153\u201360. https:\/\/doi.org\/10.2147\/JHL.S396659.","journal-title":"J Healthc Leadersh"}],"container-title":["Addiction Science &amp; Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13722-025-00643-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13722-025-00643-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13722-025-00643-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T02:03:41Z","timestamp":1769047421000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13722-025-00643-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["643"],"URL":"https:\/\/doi.org\/10.1186\/s13722-025-00643-1","relation":{},"ISSN":["1940-0640"],"issn-type":[{"value":"1940-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]},"assertion":[{"value":"27 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved in accordance with the Declaration of Helsinki by the Stanford University and University of Wisconsin institutional review boards (IRB-66398 and 2023\u2009\u2212\u20090195 respectively) with a waiver of consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10"}}