Opioid use disorder (OUD) is a chronic and relapsing condition that affects people across British Columbia (BC). People with OUD are at significant risk of morbidity and mortality related to unintentional toxic drug poisonings from the fentanyl-contaminated unregulated drug supply. Despite the unabating rates of toxic drug deaths in BC, evidence-based pharmacologic interventions for OUD remain underutilized especially in rural and remote areas of the province. Opiate agonist treatment (OAT) is an evidence-based pharmacologic intervention for OUD that is within primary care provider (PCP) scope of practice to prescribe. This integrated literature review was conducted to address how in rural and remote communities, PCPs can improve treatment outcomes for adults with OUD when prescribing OAT. A systematic search of six large academic databases was conducted that yielded twelve peer-reviewed articles that met inclusion criteria. Findings are discussed based on key themes from the literature that demonstrate an undisputed understanding of the efficacy of OAT among rural PCPs, however treatment outcomes among rural patients with OUD are variable due to several high-level social, regulatory, environmental and organizational challenges that are exacerbated in rural regions. Scale-up of accessible OAT in primary care is integral to improving treatment outcomes for adults with OUD and preventing toxic drug deaths in rural and remote BC communities.
