Abstract
INTRODUCTION The current opioid crisis in the U.S. has led to an increased number of office-based opioid treatment (OBOT) programs that provide medication for opioud use disorder (MOUD) in primary care settings. MOUD (formerly known as medication assisted treatment) requires a medication and psychosocial component of care and thus, expertise from multiple types of providers. To help inform workforce development policies and strategies to train the future OBOT workforce, this study examined: (1) the provider composition of OBOT teams, (2) team members’ respective duties, and (3) communication patterns. METHODS Interviews with a convenience sample (N=12) of providers working as members of OBOT teams in outpatient primary care settings across the U.S. Interviews were recorded and transcribed. Qualitative coding was used to identify patterns relevant to study objectives. RESULTS OBOT teams always included (1) a Drug Enforcement Administration (DEA)-waivered prescriber (typically physicians) as is mandated federally. However, other team members included; (2) a behavioral health provider (typically licensed clinical social workers); (3) a MOUD registry coordinator (varied in degree/background); and (4) other operational staff (typically medical assistants). OBOT clinics offering therapeutic behavioral interventions were more likely to employ multiple behavioral health providers, though there was variation in the types of behavioral health interventions utilized. CONCLUSION The demand for OBOT treatment teams presents a significant opportunity for interprofessional training of health professionals. Educators, policymakers, and researchers should evaluate the composition and service capacity of the current OBOT workforce in order to develop comprehensive interprofessional training programs that address the physical, psychopharmacological, behavioral health, and psychosocial components of care necessary for OUD treatment and recovery.
Highlights
The current opioid crisis in the U.S has led to an increased number of office-based opioid treatment (OBOT) programs that provide medication for opioud use disorder (MOUD) in primary care settings
Our study observed variation in the professional backgrounds of behavioral health and psychosocial providers on OBOT teams. This finding demonstrates that perhaps other OBOT team members might not be aware of the full scope of practices deployed by others on their team generally
Increasing team communication and clearly defining roles might address a providers’ reluctance to treat opioid use disorder (OUD) patients, by improving medication for opiouid use disorder (MOUD) uptake in OBOT settings and helping to prevent provider burnout
Summary
The current opioid crisis in the U.S has led to an increased number of office-based opioid treatment (OBOT) programs that provide medication for opioud use disorder (MOUD) in primary care settings. While the number of drug overdose deaths saw a 4% national decline from 2017-2018, drug overdose remains the leading cause of injury-related death in the United States (Centers for Disease Control and Prevention, 2019). In 2017, nearly two million non-elderly adults in the United States had an opioid use disorder (OUD), and of these, only 34% received any type of treatment within the past year (Orgera & Tolbert, 2019). As policymakers in the United States consider how to scale up office based opioid treatment (OBOT) services and address the growing demand for treatment that includes medication for opioid use dirsoders (MOUD), referred to as medication-assisted treatment (MAT), (Fanucchi, Springer, & Korthuis, 2019), interprofessional workforce configurations must be considered
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