title: Clinic-based treatment for opioid dependence: a qualitative inquiry.
abstract: OBJECTIVE
  To identify barriers and facilitators to treatment of opioid dependence in primary care clinics.
  
  
  METHODS
  In-depth interviews with 27 New York State clinic directors.
  
  
  RESULTS
  Stigmatizing attitudes emerged as a major barrier. Respondents often viewed opioid-dependent persons as manipulative, demanding, and disruptive. Commonly cited facilitators were physician training, increased office staffing, and greater mental health, social services, and addictions support.
  
  
  CONCLUSIONS
  Our study reveals attitudinal barriers to address and supportive factors to promote in order to increase the limited availability of office-based treatment of opioid dependence in the United States compared with other countries.
authors.affiliation: University of Pennsylvania, Philadelphia, 19104, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: McMurphy
authors.forename: Judy
authors.initials: J
authors.lastname: Shea
authors.forename: Julia
authors.initials: J
authors.lastname: Switzer
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Turner
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D002047:Buprenorphine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008691:Methadone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D010865:Pilot Projects; D011320:Primary Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone