How Primary Care Clinics Can Play a Key Role in Combating the Opioid Crisis

The United States is currently experiencing a severe opioid epidemic, with overdose deaths from synthetic opioids like fentanyl rising dramatically—over 100-fold since 1999. Medications such as buprenorphine, methadone, and naltrexone are proven effective in treating opioid use disorder (OUD), reducing relapse rates, overdoses, and fatalities. However, numerous barriers hinder access to these lifesaving treatments, including insufficient provider training and stigma faced by individuals with OUD, which discourages them from seeking specialist care.

Psychologist Erin Kelly, Ph.D., highlights that small obstacles can significantly impact those in the throes of withdrawal or addiction. In response, a team led by Dr. Kelly established a dedicated substance use disorders clinic within a primary care setting at Jefferson, complemented by a residency program focused on expanding access to medication-assisted treatment (MAT). Their objective was to create low-barrier access to medications by integrating OUD treatment within primary care, positioning these clinics as frontline responders to the crisis.

Initially, primary care providers (PCPs) received training to earn X-Waiver certification—required until 2022—to prescribe certain OUD medications. They also underwent education in harm reduction and trauma-informed care. The most significant uptick in treatment prescriptions was observed after the establishment of the specialized clinic, with patient feedback overwhelmingly positive about the ease of access and the non-stigmatizing approach by their providers.

Dr. Jaffe emphasizes that programs like this can be expanded to better equip PCPs at the front lines of the opioid epidemic. The study associated with this initiative was conducted with the support of students and postdoctoral researchers at Sidney Kimmel Medical College. According to Dr. Jaffe, enhancing primary care providers' capacity to do substance use screening and provide treatment is crucial in addressing the epidemic effectively.

Efforts such as embedding substance use disorder clinics within primary care practices demonstrate promising results in increasing treatment access and reducing stigma. It underscores the importance of empowering primary care providers with the necessary training and resources to combat one of the most pressing public health challenges today.