The opioid epidemic continues to devastate communities across the United States, claiming nearly 82,000 lives in 2022 alone, according to the National Institute on Drug Abuse (NIDA). Behind this staggering number are individuals, families, and entire support systems that are left in the wake of loss. But amidst the crisis lies a powerful, underutilized solution—one that could be offered not in specialized addiction clinics or emergency rooms, but in the offices of everyday family doctors. This is the heart of primary care opioid treatment.
Thanks to a legislative shift over two decades ago, many primary care providers (PCPs) in the U.S. are authorized to prescribe medications for opioid use disorder (MOUD), such as buprenorphine and naltrexone. These medications have been clinically proven to significantly reduce the risk of overdose, increase treatment retention, and support long-term recovery. Despite their efficacy, they remain underused—and one major reason is that most people simply don’t know that their primary care doctor can help. That’s why primary care opioid treatment deserves more visibility.
The Drug Addiction Treatment Act of 2000: A Turning Point
The Drug Addiction Treatment Act (DATA) of 2000 marked a major shift in how MOUDs could be accessed. For the first time, physicians outside of the psychiatry and addiction medicine specialties—such as family doctors and internists—were allowed to prescribe certain medications for opioid use disorder, including buprenorphine. The intention was clear: make life-saving medications more accessible by integrating treatment into routine medical care, a foundational element of primary care opioid treatment.
Over time, regulatory barriers around prescribing these medications have been further eased. For instance, the 2022 removal of the “X-waiver” requirement—previously necessary for prescribing buprenorphine—aimed to simplify the process and empower more providers to take part in addressing the opioid epidemic.
However, legal changes alone haven’t been enough. A significant gap remains between what’s legally possible and what people actually know—and that’s where public awareness becomes critical for primary care opioid treatment.
A Widespread Misconception: Who Can Prescribe MOUDs?
A 2023 study published in JAMA Network Open—funded by the National Institutes of Health (NIH)—revealed a troubling truth: most Americans are unaware that their primary care physicians can prescribe MOUDs. The study used data from the Justice Community Opioid Innovation Network (JCOIN), analyzing responses from a June 2023 survey. The results were eye-opening.
According to the study’s authors, the majority of respondents either didn’t know that PCPs could prescribe MOUDs or incorrectly believed they were prohibited from doing so. This lack of knowledge is more than just a missed opportunity—it’s a life-threatening barrier to primary care opioid treatment. When individuals don’t realize that help may be available from their trusted family doctor, they are far less likely to seek timely treatment.
The Impact of Disparities in Awareness
The study didn’t just measure general awareness—it also uncovered stark disparities in knowledge across different racial and ethnic groups. Black and white respondents were more likely than Hispanic or Latino respondents to correctly identify that primary care physicians could prescribe MOUDs. Still, nearly 20% of both Black and Hispanic/Latino respondents incorrectly stated that PCPs could not offer these medications.
These knowledge gaps reflect broader patterns of inequity in healthcare access and education, and they present a serious challenge for public health. If large portions of the population—particularly those already facing systemic barriers—remain unaware of treatment options like primary care opioid treatment, the opioid crisis will only continue to deepen in these communities.
Why MOUDs Matter: A Life-Saving Approach to Treatment
MOUDs like buprenorphine, methadone, and naltrexone are backed by a strong body of evidence showing their effectiveness in treating opioid use disorder (OUD). These medications work in different ways to stabilize brain chemistry, reduce cravings, and block the euphoric effects of opioids. More importantly, they save lives.
Research shows that people who receive MOUDs are far less likely to die from an overdose than those who do not receive medication-assisted treatment. MOUDs also improve treatment retention, reduce illicit opioid use, and help people reintegrate into daily life—including maintaining employment and stable housing. These outcomes highlight why primary care opioid treatment should be central to the nation’s response.
Contrary to some common misconceptions, these medications are not “replacing one addiction with another.” They are evidence-based treatments that manage a chronic brain disease in much the same way insulin is used for diabetes or inhalers for asthma.
What’s Stopping Primary Care Providers?
While regulatory changes have made it easier for PCPs to prescribe MOUDs, structural and systemic challenges still limit widespread adoption. Previous studies have identified several barriers that prevent providers from offering these medications, including:
- Lack of administrative support: Many practices are not equipped with the staff, workflows, or billing infrastructure needed to integrate primary care opioid treatment into routine care.
- Stigma and misinformation: Negative attitudes about substance use disorders and MOUDs persist—even among healthcare professionals.
- Fear of increased demand: Some providers worry that offering MOUDs will overwhelm their practice with patients in crisis, without adequate support.
- Limited training and mentorship: PCPs may feel unprepared to manage OUD without more specialized knowledge or access to addiction medicine consultations.
Policy and Practice Recommendations
The authors of the JAMA Network Open study—and many public health experts—have proposed a number of strategies to increase MOUD access and awareness:
Public Awareness Campaigns
Just as campaigns for HIV testing, cancer screening, and smoking cessation have educated the public and reduced stigma, similar efforts are needed for MOUDs. These campaigns should be culturally sensitive, multilingual, and tailored to specific communities to ensure broad impact for primary care opioid treatment.
Routine Screening in Healthcare Settings
Experts recommend incorporating routine screening for substance use disorders into primary care visits, emergency departments, and other healthcare settings. By proactively identifying OUD, providers can begin treatment earlier and more effectively using primary care opioid treatment strategies.
Support for Providers
To encourage more PCPs to prescribe MOUDs, systems must offer meaningful support. This could include:
- Access to addiction medicine specialists for consultation.
- Dedicated administrative help.
- Clinical workflows that integrate behavioral health and addiction support.
- Time and financial incentives for primary care opioid treatment.
Training and Continuing Education
Medical schools, residency programs, and continuing education platforms should prioritize training on MOUD prescribing. Mentorship opportunities and clinical rotations in addiction medicine can also help bridge knowledge gaps for practicing providers. When embedded within primary care opioid treatment, this education can help normalize and expand MOUD use.
The Path Forward
The opioid epidemic is one of the most urgent public health challenges of our time—but it is not insurmountable. We have the tools, the medications, and the knowledge to reduce harm and save lives. What’s needed now is broader awareness, stronger systems of support, and a commitment to equity in care.
Primary care providers are already on the front lines of healthcare. With the right resources and education, they can also become frontline responders in the opioid crisis. But for that to happen, patients must first know that their doctor can help—and providers must feel empowered to act. The future of primary care opioid treatment depends on it.
The Bottom Line
Opioid use disorder is a treatable medical condition, and recovery is possible. For many, the first step to healing could be just one conversation away—with a trusted primary care provider who knows how to help and is ready to prescribe life-saving treatment.
It’s time to bring opioid addiction care into the heart of everyday healthcare—and ensure that no one misses out on treatment simply because they didn’t know where to turn. Let’s make primary care opioid treatment a national priority.
