Importance: Medication for opioid use disorder (MOUD) (eg, buprenorphine and naltrexone) can be offered in primary care, but barriers to implementation exist.

Question: What are multidisciplinary primary care team perspectives on barriers and facilitators to expanding access to medications for opioid use disorder (MOUD)?

Findings: In this survey-based and qualitative study, 4 themes encapsulated multilevel barriers and facilitators associated with primary care team provision of MOUD during implementation: (1) structural barriers delayed or limited primary care team responsiveness to patients needing opioid-related care; (2) patient engagement was more challenging than expected; (3) prescribing clinicians needed ongoing training and tools; and (4) primary care teams had conflicting attitudes about expanding MOUD care.

Meaning: The results of this qualitative study suggest that further support is needed to address the structural barriers to MOUD provision in primary care settings.