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Table 1 System, organizational, and individual contextual barriers to MOUD

From: Stepped implementation-to-target: a study protocol of an adaptive trial to expand access to addiction medications

System-level factors

System-level factors include policy, community, and financial levers. In MOUD implementation by specialty addiction programs, system barriers include myths about prohibitive policies, historical isolation from other health care providers, and norms that do not endorse MOUD

Organization-level barriers

Organization-level barriers include leaders who may not support MOUD, a culture of anti-MOUD as “just another crutch” and inflexible daily schedules

Individual contextual barriers

Individual contextual barriers are manifest in one’s own personal experience with addiction recovery, the lack of physicians or any licensed prescriber, and addiction counselors’ fears about the “professionalization” of the field