Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder

Ann Fam Med. 2017 Jul;15(4):359-362. doi: 10.1370/afm.2099.


Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective, office-based, medication-assisted treatment, but 60.1% of rural counties in the United States lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States and found that those who were not actively prescribing buprenorphine reported significantly more barriers than those who were, regardless of whether they were treating the maximum number of patients their waiver allowed. These findings suggest the need for tailored strategies to address barriers to providing buprenorphine for opioid use disorder and to support physicians who are adding or maintaining this service.

Keywords: buprenorphine; medication-assisted treatment; mental health care; opiate addiction; opiate substitution treatment; opioid treatment programs; rural health.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Buprenorphine / supply & distribution*
  • Buprenorphine / therapeutic use
  • Drug Prescriptions / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opiate Substitution Treatment
  • Opioid-Related Disorders / drug therapy*
  • Practice Patterns, Physicians' / legislation & jurisprudence*
  • Rural Health Services*
  • United States


  • Buprenorphine