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Organizational Facilitators and Barriers to Medication for Opioid Use Disorder Capacity Expansion and Use

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Abstract

Medication for opioid use disorder (MOUD) is a key strategy for addressing the opioid use disorder crisis, yet gaps in MOUD provision impede this strategy’s benefits. The research reported here sought to understand what distinguishes low- and high-performing organizations in building and using capacity to provide MOUD. As part of a mixed methods MOUD implementation trial, semi-structured telephone interviews were conducted with personnel from low- and high-performing MOUD-providing organizations. Seventeen individuals from 17 organizations were interviewed. Findings demonstrate the importance of individual, organization, and community-level factors in supporting the building and use of MOUD capacity. Low- and high-performing organizations showed different patterns of facilitators and barriers during the implementation process. The key difference between low- and high-performing organizations was the level of organizational functioning. A better understanding of an organization’s assets and deficits at the individual, organizational, and community levels would allow decision-makers to tailor their approaches to MOUD implementation.

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Acknowledgments

The study team gratefully acknowledges the contributions of those who participated in interviews. Editorial assistance from Maureen Fitzpatrick and Judith Ganch was also greatly appreciated.

Funding

This study was supported by a grant from the National Institute on Drug Abuse (NIDA Grant R01DA030431; PI: Molfenter).

Author information

Authors and Affiliations

  1. University of Wisconsin, Institute for Clinical and Translational Research, Signe Skott Cooper Hall, 701 Highland Avenue, Madison, WI, 53703, USA

    Nora Jacobson PhD

  2. University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA

    Julie Horst MBA, Liam Wilcox-Warren BS, Alex Toy BS, Randy Brown MD, PhD & Todd Molfenter PhD

  3. Robert Straus Behavioral Science Laboratory, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA

    Hannah K. Knudsen PhD

  4. Haram Counseling, 66 Baribeau Dr Ste 8, Brunswick, ME, 04011, USA

    Eric Haram BS, LADC

  5. Yale School of Medicine, APT Foundation, One Long Wharf Drive, Suite 321, New Haven, CT, 06511, USA

    Lynn Madden PhD, MPA

Authors
  1. Nora Jacobson PhD
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  2. Julie Horst MBA
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  3. Liam Wilcox-Warren BS
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  4. Alex Toy BS
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  5. Hannah K. Knudsen PhD
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  6. Randy Brown MD, PhD
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  7. Eric Haram BS, LADC
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  8. Lynn Madden PhD, MPA
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  9. Todd Molfenter PhD
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Corresponding author

Correspondence to Nora Jacobson PhD.

Ethics declarations

All key informants provided verbal informed consent, and all study procedures were reviewed and approved by the University of Wisconsin’s Institutional Review Board.

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The authors declare that they have no conflicts of interest.

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NIDA has played no role in the study design or preparation of this manuscript. The authors are solely responsible for the content of this manuscript, which does not represent the official views of the National Institutes of Health or NIDA.

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Jacobson, N., Horst, J., Wilcox-Warren, L. et al. Organizational Facilitators and Barriers to Medication for Opioid Use Disorder Capacity Expansion and Use. J Behav Health Serv Res 47, 439–448 (2020). https://doi.org/10.1007/s11414-020-09706-4

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  • DOI: https://doi.org/10.1007/s11414-020-09706-4

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