Real-world management of opioid use disorder in primary care 2015-2019: associations between clinical practice attributes, diagnosis, and treatment.

While intervention studies within primary care have demonstrated efficacy, barriers to successful implementation and scale-up persist.

Overall, the opioid use disorder prevalence was 0.59% between 2015 and 2019.

High-prevalence practices tended to be in metropolitan areas and have a higher ratio of physicians and behavioral health providers per patient.

The concentrated distribution of patients with opioid use disorder in our study suggests that primary care practices are an important but underused tool for opioid use disorder.