Background: Medication-assisted treatment (MAT) for opioid use disorder (MAT) is encouraged for primary care use, but evidence for effectiveness when fully integrated with primary care versus provided separately is limited.

Method: We conducted a retrospective cohort study of 257 MAT patients in our family medicine clinic to assess retention in treatment for patients receiving MAT integrated with primary care compared with our MAT patients who received their primary care elsewhere.

Results: At 1 year after enrollment, 60% of patients receiving MAT integrated with primary care remained in treatment versus 43% of patients who received their primary care separately. In multivariate analysis, the patients receiving integrated MAT had a significantly lower risk of dropout (hazard ratio 0.49, 95% CI, 0.33-0.72).

Conclusion: In this rural family medicine clinic, MAT integrated with primary care was associated with higher retention in treatment. Providing MAT as a component of comprehensive primary care may be superior to referring patients to an outside source.