Table 1.

High level of MOUD adoption among organizations whose leaders do and do not endorse barriers to implementation

Category	Barrier	Total	Leaders who endorse barrier %, N		Leaders from high-MOUD-adopting organizations who endorse barrier %, N		Leaders from high-MOUD-adopting organizations who do not endorse barrier %, N		χ2a	p-value
MOUD-belief Barriersb	Cognitive impairment in patients that interferes with their treatment	42	30.9%	13	7.7%	1	62.1%	18	10.83	<.01
	Too many patients with medical conditions that make MOUD clinically inappropriate for them	43	23.3%	10	10.0%	1	57.6%	19	7.03	.01
	Too many patients with psychological conditions that make MAT clinically inappropriate for them	43	20.9%	9	11.1%	1	55.9%	19	5.70	.02
	Negative physical consequences for patients (i.e. skeletal, dental, hormonal)	41	46.3%	19	15.8%	3	72.7%	16	11.02	<.01
	Using medications to treat addiction is substituting one drug for another	43	25.6%	11	18.2%	2	56.3%	18	4.77	.03
	Our patients are not interested in using MOUD	43	39.5%	17	23.5%	4	61.5%	16	5.92	.02
	There are better alternatives to using medications to treat OUD	43	37.2%	16	25.0%	4	59.3%	16	4.77	.03
	Too many patients divert or sell buprenorphine	43	67.4%	29	34.5%	10	71.4%	10	5.17	.02
	Too many patients mix MOUD with other medications to get high	41	61.0%	25	36.0%	9	68.8%	11	4.18	.04
	Not enough evidence that OUD treatment medications are clinically effective	43	20.9%	9	33.3%	3	50.0%	17	0.79	.37
Workforce Barriers	Our counselors do not support the use of medications for OUD	43	20.9%	9	11.1%	1	55.9%	19	5.70	.02
	Lack of staff with expertise in MOUD	43	48.8%	21	23.8%	5	68.2%	15	8.28	<.01
	Having medications like buprenorphine on-site is triggering to our staff	43	18.6%	8	50.0%	4	45.7%	16	0.05	.83
	Having patients on medications like buprenorphine is triggering to our staff	43	18.6%	8	50.0%	4	45.7%	16	0.05	.83
Regulatory Barriers	State regulations limit our ability to prescribe MOUD	42	33.3%	14	28.6%	4	57.1%	16	3.04	.08
	Federal regulations limit our ability to prescribe MOUD	43	37.2%	16	31.3%	5	55.6%	15	2.39	.12
	X-waiver requirements limit our ability to prescribe MOUD	42	42.8%	18	38.9%	7	54.2%	13	0.96	.33
Organizational Barriers	Medications for treating OUD are inconsistent with this center’s treatment policy	43	18.6%	8	25.0%	2	51.4%	18	1.83	.18
	Inadequate information about how to implement MOUD	43	18.6%	8	25.0%	2	51.4%	18	1.83	.18
Funding Barriers	Inadequate reimbursement for the costs of purchasing MOUD	42	59.5%	25	40.0%	10	58.8%	10	1.43	.23
	Inadequate reimbursement for the physician time needed to implement MAT	42	73.8%	31	45.2%	14	54.5%	6	0.29	.59
	Inadequate reimbursement for the laboratory tests needed to implement MAT	42	64.3%	27	48.1%	13	46.7%	7	0.01	.93

^adf = 1.

^bBeliefs people have about the medication, its efficacy, and its effects on their patients.