This study is a one group, cross-sectional survey study. Active buprenorphine (BUP) prescribers will be recruited to participate in an online survey of clinical program features, characteristics of patients with opioid use disorder (OUD), patients’ experience with precipitated withdrawal during BUP induction, and patients’ fentanyl use at a single time point. Millennium Health (MH) will provide urine drug test (UDT) results from the counties of prescribers who participated in the survey. Both the survey and UDT results will be obtained from addiction treatment clinics. The UDT results and survey data will be merged at the county level to assess the association between precipitated withdrawal issues and fentanyl, fentanyl analogues, and other drugs of abuse.

Study aims are to: Aim 1: Conduct a survey of licensed community pharmacists to study their knowledge of, attitudes about, and intention to provide patient care and services for SRT and MOUD; and Aim 2: Conduct a qualitative interview of a sample of up to 50 survey participants (range: 20 to 50 participants) from Aim 1 to further assess survey participants’ interest in implementing preventive care services for SUDs and medication therapy management for patients with opioid use disorder (OUD) in their practice. Together, the results will inform pharmacy-based study designs and future directions for the NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) studies as well as training and educational needs for community pharmacists.

When a patient is at elevated risk of suicide, the PCC will be prompted by Opioid Wizard to complete the Columbia-Suicide Severity Risk Scale (CSSRS), easily available to all PCCs in the EHR and saved as discrete data elements. Risk-based (depending on CSSRS score) referral and follow-up recommendations for suicide prevention will be given, with specific care recommendations ranging from care as usual (very low risk) to referral to behavioral health for evaluation and safety planning (moderate to high risk) to immediate evaluation in the emergency department and potential inpatient admission (very high risk), building on workflows developed for use by care managers in in our recently completed suicide prevention trial of over 19,000 people at elevated risk of suicide.