Buprenorphine provider preferences to expanding harm reduction services in rural and suburban primary care settings: a short report.

Introduction: The opioid overdose crisis continues to worsen in suburban and rural regions. Expanding harm reduction approaches in primary care offers a patient-centered approach to reduce opioid overdoses.

Methods: We conducted a semi-structured survey among 26 buprenorphine prescribers to assess acceptability of office-based harm reduction strategies for people who use opioids (PWUOs) and expanding partnerships with community stakeholders to ensure low-threshold access to buprenorphine.

Results: Respondents were mostly very or somewhat supportive of providing HIV testing (96.2%), information on opioid overdose prevention (100%), safe syringe disposal (100%) and use (100%), and referrals to free HIV testing (100%), social services (100%), naloxone sales in community pharmacies (96.2%) and partnering with pharmacists to facilitate referrals for patients requesting buprenorphine treatment (84.6%). Suggested strategies for enhancing care for PWUOs included addressing insurance-related barriers (e.g., prior authorization requirements, insufficient reimbursements), lifting of limits on patients prescribed buprenorphine, allowing for safe-injection sites, lifting urine drug testing requirements, integrating social services and mental health providers within primary care, and expanding the use of telebuprenorphine services.

Conclusion: Findings from this study suggest strong buprenorphine provider support for adopting harm reduction strategies in primary care and collaborating with community pharmacists to facilitate referrals for PWUOs.