1. C. Holly A. Andrilla, MS,
  2. Cynthia Coulthard, MPH and
  3. Eric H. Larson, PhD

Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective, office-based, medication-assisted treatment, but 60.1% of rural counties in the United States lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States and found that those who were not actively prescribing buprenorphine reported significantly more barriers than those who were, regardless of whether they were treating the maximum number of patients their waiver allowed. These findings suggest the need for tailored strategies to address barriers to providing buprenorphine for opioid use disorder and to support physicians who are adding or maintaining this service.


This is an easily-resolved problem; how is it fixed? 2-prong approach.

  1. Stop the legislative bullcrap of only allowing “X” number of patients to be treated by any one provider!
  2. How do we get folks to do new things, things they’re reluctant to do?  That’s EA$Y!!  $Make it worth their while$.

Primary care is woefully underpaid for the work that they do.  You want to meet the patient where the problem is?  It’s in every primary care office in this country every day!

Why did Willie Sutton rob banks?  ‘Cause that’s where the money is!

Less talk, more legislative action & $$  At least we have a president who understands the many languages $$ is fluent in!

Dr. Raymond Oenbrink
Latest posts by Dr. Raymond Oenbrink (see all)