Barriers and facilitators to scaling up medications for opioid use disorder in Kentucky: qualitative perspectives of treatment organisation staff

Background
Many people who could benefit from medications for opioid use disorder (MOUD) aren’t receiving them. This study looks at how MOUD agencies in Kentucky are experiencing changes in patient numbers and the challenges and supports they face when trying to expand services.

Methods
Researchers interviewed 66 staff members from 30 MOUD agencies across eight counties in Kentucky between December 2022 and June 2023. Participants included administrators, prescribers, and other staff. The interviews focused on what helps or hinders the growth and retention of patients in MOUD programs.

Results
Most agencies reported small increases in patient numbers and some were able to offer same-day or next-day treatment. Barriers to expanding MOUD included limited space, staffing, strict policies, and patient challenges like lack of transportation, housing, and childcare. Stigma in the community also played a role in limiting growth.

Conclusions
While there has been some progress in expanding MOUD, many challenges remain. Addressing them will require changes in policy, reductions in stigma, and better community support systems, such as transportation and housing.