Nationally, approximately three million people have or have had an opioid use disorder (OUD) — including from both prescription opioids and illicit drugs. Medications for opioid use disorder (MOUD) offer an evidence-based approach to managing OUD, promoting recovery, and saving lives. Medications approved by the U.S. Food and Drug Administration — buprenorphine, methadone, and naltrexone, often provided in combination with behavioral therapy — are considered the gold standard for OUD treatment. Despite this, MOUD remains under-prescribed by health care providers and many people with OUD do not have access to these medications.

Federally qualified health centers (FQHCs) offer critical opportunities to increase access to MOUD. A key facet of the health care safety net, FQHCs provide essential health services to underserved and historically marginalized communities in more than 15,000 locations across the nation. Over the past decade, FQHCs have strengthened their capacity to provide MOUD, however opportunities exist to further support the integration of these medications and other treatment for people with OUD into these health centers.

To identify opportunities to increase access to MOUD in FQHCs, the Center for Health Care Strategies and The Pew Charitable Trusts conducted an environmental scan exploring opportunities and challenges to offering MOUD within health centers. The scan included a literature review and interviews with stakeholders working in state and federal policy, within health centers, and at state primary care associations. Drawing from the scan, this report summarizes barriers and facilitators to providing MOUD at FQHCs and outlines opportunities at the health center, state, and federal level to support the clinical, organizational, and financial capacity to increase access to MOUD.

See also the companion case study series, Integrating Medications for Opioid Use Disorder at FQHCs, that explores how four FQHCs in various settings across the nation are incorporating MOUD treatment into clinical practice.