Not in my treatment center: Leadership's perception of barriers to MOUD adoption

Rebecca E. Stewart, Nicholas C. Cardamone, David S. Mandell, Nayoung Kwon, Kyle M. Kampman, Hannah K. Knudsen, Christopher W. Tjoa, Steven C. Marcus

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Despite their well-established effectiveness, medications for opioid use disorder (MOUD) are widely underutilized across the United States. In the context of a large publicly funded behavioral health system, we examined the relationship between a range of implementation barriers and a substance use disorder treatment agency's level of adoption of MOUD. Methods: We surveyed leadership of publicly funded substance use disorder treatment centers in Philadelphia about the significance of barriers to implementing MOUD related to their workforce, organization, funding, regulations, and beliefs about MOUD's efficacy and safety. We queried leaders on the percentage of their patients with opioid use disorder who receive MOUD and examined associations between implementation barriers and MOUD adoption. Results: Ratings of regulatory, organizational, or funding barriers of respondents who led high MOUD adopting agencies (N = 20) were indistinguishable from those who led agencies that were low adopting of MOUD (N = 23). In contrast, agency leaders who denied MOUD-belief or workforce barriers were significantly more likely to lead high-MOUD-adopting organizations. Conclusions: These findings suggest that leadership beliefs about MOUD may be a key factor of the organizational decision to adopt and should be a target of implementation efforts to increase direct provision of these medications.

Original languageEnglish
Article number108900
JournalJournal of Substance Abuse Treatment
StatePublished - Jan 2023

Bibliographical note

Publisher Copyright:
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  • Leadership
  • MAT
  • Medications for opioid use disorder
  • Stigma

ASJC Scopus subject areas

  • Psychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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