The aims of this study are to assess psychiatrists' comfort using office-based opiate agonist treatment (OBOT) and to identify psychiatrist characteristics associated with OBOT comfort. A random sample of 2,323 AMA Masterfile of Physicians psychiatrists were surveyed through the 2002 APIRE National Survey of Psychiatric Practice (NSSP). Of the 52% responding (N = 1,203), 80.6% (SE = 1.8%) were not comfortable providing OBOT. Males, addiction-certified psychiatrists, and those treating substance abuse patients were more comfortable providing OBOT. These findings highlight significant barriers in providing buprenorphine treatment. Increasing the understanding of specific financing and services delivery barriers that clinicians face is needed to inform the development of effective integrated services models and policies to facilitate OBOT implementation.