Setting

Setting barriers and facilitators often relate to the existing capacities and current responsibilities of the service organizations where buprenorphine programs are being implemented.

Barriers

The existing organizational culture and operational workflow of these new settings can sometimes impede buprenorphine program implementation. In emergency departments and primary care physicians’ offices, where patient volume is high and there is limited time to spend with individual patients, a frequently cited barrier is the amount of time and coordination required to provide patient education, monitoring (i.e., drug screening), and communication with external partners and service organizations for appropriate aftercare and follow-up.

Facilitators

Many settings already have the infrastructure in place to support buprenorphine administration and prescribing, such as electronic ordering systems, pharmacists, medication management systems, nurses, and prescribers with DEA licenses.