| Staff attitudes and conflict regarding the use of methadone in the treatment of heroin addiction |
(Brown, Jansen, &Bass, 1974) |
4 staff populations associated with five facilities of the D.C. Narcotics Treatment Administration; 25 administrators and supervisors, 21 ex-addict counselors being maintained on methadone, 22 ex-addict counselors (abstinent), 20 non-addict counselors |
Questionnaires |
Characterization of MMT patients as functioning more effectively than heroin users (greater degree of self-control/awareness) Significant difference between PWID on methadone and abstinent addicts, with abstinent addicts seen as functioning more effectively Staff attitudes include basic ambivalence toward MMT; positive attitude toward helping clients become independent of heroin, but long term MMT was not desired “…formerly addicted counselors who were functioning free of all drugs also saw addicts who had become abstinent as significantly more capable of relating effectively to others while methadone patients were seen as comparatively antisocial in their relationships”. |
| Methadone maintenance treatment: a ten-year perspective |
(Dole & Nyswander, 1976) |
Opinion piece |
Not Applicable |
The author believes that “methadone maintenance, as part of a supportive program, facilitates social rehabilitation, but methadone treatment clearly does not prevent opiate abuse after it is discontinued…” There is a noted absence of major toxicity or allergy with methadone Widely believed misinformation is continuously circulated by anti-methadone agencies on the medical effects of methadone The availability of methadone on the black markets has not increased the number of new addicts, as virtually all of the persons use methadone illicitly have previously used heroin |
| Methadone treatment: It ain’t what it used to be |
(Newman, 1976) |
Not applicable |
Opinion |
It is a myth that MMT is substituting one drug for another “Ultimately, effective treatment must be measured in terms of our patients’ reintegration into society, and as long as that society remains hostile, viewing the methadone patient as just another form of dope fiend, meaningful rehabilitation is precluded.” |
| A point of view concerning treatment approaches with narcotic antagonists |
(Resnick & Schuyten-Resnick, 1976) |
A Physician and a social worker |
Opinion piece and case report |
With naltrexone, it is essential that the staff help patients learn that treatment is not the medication alone; staff must also believe this Clinic attendance is a crucial issue and must be based on a strong desire to remain drug-free, fear of family or other external pressure, or a good relationship with their therapist Patients on naltrexone do not fear the side effects of withdrawal when compared to methadone |
| Love and hate in methadone maintenance |
(Davidson, 1977) |
A patient and staff population at a methadone maintenance clinic |
Opinion |
Workers in MMT are accustomed to the diminished capacity patients possess to control their emotions Patients often” choose” one staff member in the clinic and develop a dependent relationship to them The behavior we see in patients in MMT could be a manifestation of patients’ daily life and environment |
| Attitudes and beliefs of staff working in methadone maintenance clinics |
(J. R. Caplehorn, Irwig, & Saunders, 1996a) |
90 staff members working in 10 public methadone maintenance units in the Sydney, Australia metropolitan area in 1989 |
Survey |
Staff were aware of the benefits of MMT Staff thought that addicts should not be offered indefinite maintenance treatment Many staff were led by personal beliefs that those on methadone maintenance should remain abstinent from other drug use “We conclude that support for abstinence-oriented policies was not associated with a lack of faith in the efficacy of methadone maintenance but rather was strongly associated with a generally punitive attitude to illicit drug use.” |
| Physicians’ attitudes and retention of patients in their methadone maintenance programs |
(J. R. Caplehorn, Irwig, & Saunders, 1996b) |
90 staff members working in Sydney, Australia’s 10 public methadone clinics, and 280 patients |
Survey |
“… doctor’s scores on a scale measuring commitment to abstinence-oriented policies were significantly associated with retention of patients in their programs.” Abstinence-oriented physicians prescribed lower doses of methadone, which contributed to lower levels of retention |
| Changing attitudes and beliefs of staff working in methadone maintenance programs |
(R. M. Caplehorn, Lumley, Irwig, & Saunders, 1998) |
90 staff in 1989 92 in 1992 33 respondents participated in both |
Voluntary survey in 1989 and 1992 |
|
| Staff attitudes and retention of patients in methadone maintenance programs |
(J. R. Caplehorn, Lumley, & Irwig, 1998) |
Staff working in six public methadone programs in Sydney, Australia |
Survey |
“The stronger the commitment to abstinence-oriented policies the worse the retention” “It is estimated that 50% of ex-prisoners and 41% of other patients would have left an abstinence-oriented program in the first six months treatment compared with 9% of ex-prisoners and 15% of others treated in an indefinite maintenance program. |
| French general practitioners’ attitudes toward maintenance drug abuse treatment with buprenorphine |
(Moatti, Souville, Escaffre, & Obadia, 1998) |
1186 French GPs |
Telephone interviews |
Familiarity with the use of opiates for pain management is associated with a positive attitude toward buprenorphine Willingness to prescribe buprenorphine was low among GPs w/o prior experience with IDU GPs with an interest in psychoanalysis were more likely to be accepting of BMT |
| Methadone maintenance in general practice: impact on staff attitudes |
(Langton et al., 2000) |
31 General Practitioners (GPs), 23 receptionists in 23 Dublin general practices |
Questionnaire sent before patient’s first visit and 6 months later |
GPs held a positive attitude toward using methadone with stabilized patients 68% of participants experienced abusive or disruptive behavior 41% said their stress levels were above average At the end of the study, all participants said they would continue to prescribe methadone but would need specialist services |
| Office-based methadone prescribing: acceptance by inner-city practitioners in New York |
(McNeely, Drucker, Hartel, & Tuchman, 2000) |
71 providers from 11 sites in New York |
Survey |
70% said they were comfortable managing care of drug users; 72% were convinced of methadone’s effectiveness and support its usage 66% of providers would prescribe methadone HIV/AIDS providers were most enthusiastic about prescribing methadone (88%) 52% support setting no limit on the duration of MMT |
| Response: challenging perspectives on Methadone Maintenance Treatment |
(Benton, 2001) |
Opinion piece by chair of the national association of opioid treatment providers |
Opinion |
Different philosophies of MMT
MMT suffers a bad reputation
“Current policy… puts too much emphasis on protecting society from methadone, and not enough on protecting society from the epidemics of addiction, violence, and infectious disease that methadone can help reduce” Diverting methadone is often seen as a bane for MMT services
|
| Methadone treatment in Ontario after the 1996 regulation reforms results of a physician survey |
(Fischer, Cape, Daniel, & Gliksman, 2002) |
64 Ontario physicians |
Interview |
Over half the physicians viewed MMT through a “harm reduction” framework Two out of five physicians felt the most critical need in MMT is counseling services Many physicians felt that there was a need for a “considerable knowledge base” among methadone doctors and continuing medical education |
| Provider satisfaction with office-based treatment on opioid dependence: a systematic review |
(Becker & Fiellin, 2005) |
Academic literature |
Systematic review |
Bouchez and Vignnau’s study found that most GPs said their relationships with opioid dependent patients improved after buprenorphine was prescribed Fiellin’s study’s outcome was that GPs found MMT patients to be punctual, compliant, reliable to pick-up and return medication bottles, honest about illicit use, courteous with staff |
| Buprenorphine diffusion: the attitudes of substance abuse treatment counselors |
(Knudsen, Ducharme, Roman, & Link, 2005) |
2,298 counselors in community-based treatment programs 2002–2004 |
Questionnaires |
Training is a factor in favorable attitudes toward buprenorphine Counselors are more likely to report buprenorphine as effective when receive buprenorphine-specific training Counselors with a higher educational degree were more likely to report buprenorphine as acceptable “Of the internet-related measures, the indicator of NIDA website use approached significance (p = .05), with greater NIDA website use being associated with a reduced likelihood of a ‘don’t know’ response” “… continued efforts to disseminate information about buprenorphine are needed”. |
| Clinic-based treatment for opioid dependence: a qualitative inquiry |
(McMurphy, Shea, Switzer, & Turner, 2006) |
Directors at 26 clinics in New York State, three physicians from the University of Pennsylvania |
Interview |
56% clinic directors expressed willingness to offer methadone, while 65% expressed interest in prescribing buprenorphine Clinic directors mentioned: difficult, manipulative, arguing, complaining, unemployed, and undesirable as words to summarize their views on methadone-treated patients 48% were concerned about bringing “street culture” into their clinic Over 90% had negative opinions on methadone-treated people |
| Difficulties associated with outpatient management of drug abusers by general practitioners: a cross-sectional survey of general practitioners with and without methadone patients in Switzerland |
(Pelet, Besson, Pecoud, & Favrat, 2005). |
352 GPs who treat MMT patients and 231 GPs who do not |
Questionnaires |
Most practitioners with MMT patients were interested in investing time into further training Lack of training was mentioned by providers with MMT patients as an area of improvement Both groups mentioned the need for more political support for treatment of drug-addicted patients and need for more accessible specialists |
| Support for buprenorphine and methadone prescription to heroin-dependent patients among New York City physicians |
(Coffin et al., 2006) |
770 New York Physicians, 247 respondents |
Random postal survey |
Willingness to prescribe methadone or buprenorphine was correlated to: More recent year of licensure Working in a hospital (as opposed to outpatient setting) Being a director of a clinic |
| Attending physicians’ and residents’ attitudes and beliefs about prescribing buprenorphine at an urban teaching hospital |
(Cunningham, Sohler, McCoy, & Kunins, 2006) |
99 residents and attending physicians |
In-person interviews and questionnaires |
Most respondents knew buprenorphine as a treatment option Only 37.8 % felt that primary care providers should be able to prescribe 35.7% reported interest in prescribing buprenorphine 72.1% were motivated to prescribe if given the proper training and structural support |
| Experiences of a national sample of qualified addiction specialists who have and have not prescribed buprenorphine for opioid dependence |
(Kissin, McLeod, Sonnefeld, & Stanton, 2006) |
Random sample of 545 waivered addiction specialist physicians |
Survey |
|
| Attitudes and beliefs toward methadone maintenance treatment among Australian prison health staff |
(Gjersing, Butler, Caplehorn, Belcher, & Matthews, 2007) |
202 staff employed by Justice Health New South Wales |
Survey |
“Correctional health staff tend to be more abstinence-oriented, more likely to disapprove of drug use, and less knowledgeable about the risks and benefits of methadone than Australian community methadone staff. The findings have important implications for training health staff working in the prison environment with regard to client retention on methadone treatment” Level of abstinence-orientation and disapproval of drug use among correctional health staff was higher than in the community |
| Nurse practitioner and physician assistant interest in prescribing buprenorphine |
(Roose, Kunins, Sohler, Elam, & Cunningham, 2008) |
511 non-physician providers |
Questionnaire |
|
| A pilot survey of attitudes and knowledge about opioid substitution therapy for HIV-infected prisoners |
(Springer & Bruce, 2008) |
27 infectious disease nurses, case managers, social workers and drug counselor |
Anonymous survey |
More respondents answered “unknown” to questions regarding buprenorphine use when compared to methadone 48% of respondents agreed with the belief that opioid substitution treatment does not increase HIV risk taking behavior 59% felt that opioid substitution treatment was substituting one addiction for another |
| Use of buprenorphine for addiction treatment: perspectives of addiction specialists and general psychiatrists |
(Thomas et al., 2008) |
495 physicians: 224 non-addiction specialist psychiatrists, and 271 addiction specialists |
Survey |
16% of non-addiction specialist psychiatrists indicated that they had not heard about buprenorphine prior to the survey “Results indicate that most addiction specialists have adopted it, but beyond addiction specialists, few other clinicians have incorporated it into practice”. Barriers to prescribing buprenorphine for both groups included: “It does not fit in with my practice,” “It would change the patient mix undesirably,” and that “prescribing is too complex.” |
|
|
|
|
|
| Integrating buprenorphine treatment into office-based practice: a qualitative study |
(Barry et al., 2009) |
23 practicing office-based physicians in New England |
Interviews |
Physicians report feeling discomfort implementing BMT because of lack of expertise in treating addiction Physicians noted that cost of buprenorphine was a barrier to care Participants noted that office-based buprenorphine treatment offered a greater continuity of care for patients Some providers attributed lack of knowledge or interest in treating psychiatric and medical disorders that are often comorbid with OUD as barriers to implementing buprenorphine treatment “…respondents viewed [BMT] as a positive alternative to [MMT]: they emphasized the medical focus of [BMT] and its reduced stigma relative to MMT.” Providers believe patients are satisfied with BMT, especially in the primary care environment |
| Buprenorphine in maintenance treatment: experience among Italian physicians in drug addiction centers |
(Gjersing et al., 2007; Quaglio et al., 2010) |
185 randomly selected physicians from Italy with at least 6 months of experience with buprenorphine |
Questionnaire |
More physicians consider buprenorphine useful for long replacement periods than short replacement period An advantage of buprenorphine: it is easy to trust with take-home medication; a disadvantage: potential diversion Providers do not consider buprenorphine better than methadone in patients with dual diagnosis |
| Attitudes toward evidence-based pharmacological treatments among community-based addiction treatment programs targeting vulnerable patient groups |
(Krull, Lundgren, & Zerden Lde, 2011) |
296 program directors from community-based substance abuse treatment organizations, and 518 clinical staff |
Phone interviews and web-surveys |
Program directors in organizations serving clients with a high percentage of homelessness and severe and persistent mental illness had significantly more negative attitudes toward buprenorphine Directors who worked in organizations that were affiliated with a university or hospital, and had a higher number of annual admissions reported more positive attitudes about buprenorphine |
| Prescribers’ perceptions of the diversion and injection of medication by opioid substitution treatment patients |
(Larance et al., 2011) |
291 OST prescribers in Australia |
Mail survey |
Most prescribers perceived that their clients did adhere to their OST More buprenorphine patients were identified as diverting unsupervised doses compared to methadone patients and buprenorphine-naloxone patients |
| A multi-level analysis of counselor attitudes toward the use of buprenorphine in substance abuse treatment |
(Rieckmann, Kovas, McFarland, & Abraham, 2011) |
1093 counselors from 234 facilities in 40 states |
Survey |
Counselors were more likely to perceive buprenorphine as acceptable if their facility had already adopted buprenorphine Counselors with buprenorphine-specific training were more likely to see it acceptable Counselors employed in programs with national accreditation were more likely to view buprenorphine as an effective treatment |
| Clinician beliefs and attitudes about buprenorphine/naloxone diversion |
(Schuman-Olivier et al., 2013) |
369 American clinicians |
Completed a 34-item survey during two national symposia on opioid dependence |
Providers’ preconceived beliefs about diversion correlated to the level of perceived danger about buprenorphine/naloxone (B/N) Education level of the provider was not associated with level of perceived danger of B/N diversion |
| Barriers to primary care physicians prescribing buprenorphine |
(Hutchinson, Catlin, Andrilla, Baldwin, & Rosenblatt, 2014) |
92 physicians |
Interview |
Most respondents reported positive beliefs about buprenorphine but only 28% reported actually prescribing it Most new prescribers were family medicine doctors No institutional support was cited as a reason for not prescribing buprenorphine |
| Diversion of methadone and buprenorphine from opioid substitution treatment: a staff perspective |
(Johnson & Richert, 2014) |
25 professionals working in OST (7 nurses, 7 counselors/case workers, 6 physicians, 3 department heads, 1 psychiatric aide, and 1 psychologist) in southern Sweden |
Qualitative interviews |
22 out of 25 interviewees voiced negative opinions about diversion One stated that methadone can be more dangerous than heroin (because of longer half-life) 15 considered methadone and buprenorphine safer than heroin “Buprenorphine is more highly sought after since it gives you a greater kick, if taken in small doses, and in particular if the user hasn’t developed any tolerance…” Many voiced concerns about diversion damages the legitimacy of OST, that methadone is seen as part of the general narcotics supply |
| Buprenorphine diversion and misuse in outpatient practice |
(Lofwall et al., 2014) |
Discussions from expert addiction medicine providers from 3 different countries of a theoretical case of a patient in office-based treatment for OUD |
Clinical case conference and 3 commentaries |
Supervised dosing is an uncommon method of diversion prevention in the U.S, but is widely used in France and Australia In France: those with risk factors are strongly encouraged to have supervised dispensing for as long as possible In Australia: supervised dosing is required for the first three months of methadone or buprenorphine treatment, the cost of this is higher than oxycodone or morphine; specialist addiction clinics are often stigmatized and associated as services for heroin users |
| Preliminary survey of office-based opioid treatment practices and attitudes among psychiatrists never receiving buprenorphine training to those who received training during residency |
(Suzuki, Connery, Ellison, & Renner, 2014) |
93 psychiatrists |
Survey |
Those who completed buprenorphine training were more likely to be male and to report confidence in treating OUD Those who completed buprenorphine training were less likely to report barriers to prescribing buprenorphine 81 % of psychiatrists felt all psychiatry residents should be offered buprenorphine training |
| Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians |
(DeFlavio, Rolin, Nordstrom, & Kazal, 2015) |
108 family physicians practicing in Vermont or New Hampshire |
Survey |
Most commonly cited barrier to providing BMT was a lack of staff preparedness Barriers to BMT treatment included inadequately trained staff, insufficient time, inadequate office space, and cumbersome regulations Approximately half (52%) of family physicians felt that there should be special remuneration for prescribing buprenorphine |
| Implementing buprenorphine in addiction treatment: payer and provider perspectives in Ohio |
(Molfenter et al., 2015) |
18 County board participants and 36 provider agency participants in Ohio |
Interviews |
County boards stated support for use of buprenorphine because of escalating rates of opioid dependence/opioid crisis, need for better care, integration with general health care Desire for better clinical care for opioid misuse was expressed Some providers believe that using MOUD is substituting one drug for another Providers believe more training and better understanding of buprenorphine would make it more readily accepted Some physicians did not want to prescribe buprenorphine because of concerns of working with addicted clientele |
| Methadone maintenance treatment programs in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran |
(Moradi et al., 2015) |
MMT providers including prison directors and managers, physicians and nurses, consultants and psychologists |
Focus group discussions |
Participants said MMT program reduced entry of drugs into the system as well as the demand for trade of drugs and cigarettes Participants held the belief that the MMT program could keep addicts calm in prison and decrease crime Belief that MMT increased addicts’ desire to quit drugs in prisons View that MMT reduced transmission of disease through shared injections MMT programs improve addicts’ personal and social lives, bringing them back in the community MMT made training and counseling programs more effective for addicts |
| Extended-release naltrexone: a qualitative analysis of barriers to routine Use |
(Alanis-Hirsch et al., 2016) |
Addiction treatment center staff and health plan personnel |
Interview |
Cost of XR-NTX affects patient’s willingness to use it Participants report difficulty in initiation of treatment XR-NTX is not included in many health plans, which leads to frustration at lack of access Treatment centers struggle with staffing |
| Counselor training and attitudes toward pharmacotherapies for opioid use disorder |
(Aletraris, Edmond, Paino, Fields, & Roman, 2016) |
Administrator and clinical director of 307 treatment programs |
Interview |
Participants had higher acceptance for BUP than MMT Stigma of opioid agonist medications (especially MMT) were due to concerns of diversion, drug substitution, and negative side effects Proper training is associated with higher acceptance of MOUD |
| How to overcome hurdles in opiate substitution treatment? A qualitative study with general practitioners in Belgium. |
(Fraeyman, Symons, Van Royen, Van Hal, & Peremans, 2016) |
General Practitioners in Antwerp, Belgium |
Focus groups and interviews |
General practitioners (GP) often feel anxious about treating patients with addictions with OST (opiate substitution treatment) because of the reputation of patients who misbehave General practitioners cite lack of experience and/or collaboration with addiction centers as a barrier to prescribing OST; the same physicians also showed no willingness to participate in training/ information sessions about prescribing OST Practitioners see the advantage of providing OST outside of addiction centers (safe, private, and less stigmatizing), but patients must pay a fee at the GP office |
| Shifting blame: buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America |
(Hatcher, Mendoza, & Hansen, 2018; Mendoza, Rivera-Cabrero, & Hansen, 2016) |
53 participants total; buprenorphine prescribers at 9 hospitals and 3 Veterans’ Affairs Medical Centers in NYC that offered outpatient methadone and/or buprenorphine treatment; private prescribers in NYC |
Interview |
67% of physicians felt that 8 hours of training required for buprenorphine certification worked against providers becoming buprenorphine certified because it could not easily be attended with providers’ busy schedules More than half of participants felt that the DEA was a deterrent from offering buprenorphine treatment Prescribers expressed that other physicians were hesitant about providing buprenorphine because of the stigmatized nature of opioid dependent patients |
| Buprenorphine maintenance treatment of opiate dependence: correlations between prescriber beliefs and practices |
(MacDonald, Lamb, Thomas, & Khentigan, 2016) |
30 buprenorphine qualified prescribers in the San Diego County area |
Internet questionnaire |
Most participants believed that patients on BMT were functioning well and are in recovery 67% believed that some prescriber’s practices increase diversion 47% believed that there is negative stigma for BMT in the community Endorsement of the 12-step model was positively correlated with the belief that a patient on BMT is “in recovery” Most maintenance research studies are one year or less - yet 40% of the sample reported treating patients over one year, demonstrating the need for long-term data for community-based treatment |
| Why aren’t physicians prescribing more buprenorphine? |
(Huhn & Dunn, 2017) |
558 physicians with and without the waiver to prescribe buprenorphine |
Survey |
Reasons for minimal BUP prescribing: not enough time for additional patients, not knowing how to get the waiver, insufficient reimbursement, concerns about diversion Resources that may help physicians prescribe BUP more were information about local counseling resources and being paired with an experienced provider 55% of waivered providers that were not prescribing to their capacity and 34% of nonwaivered physicians reported that nothing would increase their willingness to prescribe buprenorphine |
| Medication-assisted treatment should be part of every family physician’s practice: Yes |
(Loxterkamp, 2017) |
Opinion Piece |
Opinion |
|
| Knowledge and stigma regarding methadone maintenance treatment and non-methadone maintenance treatment addiction facilities in Israel |
(Shidlansik, Adelson, & Peles, 2017) |
Staff at buprenorphine and MMT clinics in Israel; 63 total staff from 11 MMT clinics, 46 staff from SSD (social service department) facilities |
Questionnaire |
SSD staff had more negative beliefs about MMT than MMT staff, stating that “[MMT] encourages drug use”, “is bad for health.” SSD group stigmatized MMT more than the MMT group; correlation between knowledge and acceptance of MMT |
| Commune health workers’ methadone maintenance treatment (MMT) knowledge and perceived difficulties providing decentralized MMT services in Vietnam |
(C. Lin, Tuan, & Li, 2018) |
300 commune health workers from 60 communes in Vietnam |
Survey |
|
| Perceptions and practices addressing diversion among US buprenorphine prescribers |
(L. A. Lin, Lofwall, Walsh, Gordon, & Knudsen, 2018) |
1,174 buprenorphine prescribers currently treating at least one OUD patient with buprenorphine |
Mail survey |
Majority of prescribers report assessing all patients for buprenorphine diversion. Providers assess for diversion through frequent visits early in treatment, urine screens for buprenorphine, and using medication counts when diversion is suspected Over 50% were willing to terminate patients for diversion Physicians who perceived greater diversion reported seeing patients more frequently |
| Primary care physicians’ views about prescribing methadone to treat opioid use disorder |
(Livingston, Adams, Jordan, MacMillan, & Hering, 2018) |
20 primary care physicians in various sized communities throughout Nova Scotia, Canada |
Interviews |
Physicians noted patients expressed access to methadone expertise from a provider who has experience prescribing this medication as a factor Help from allied professionals needed Patient-related factors include physician’s reporting people with substance use disorders as a difficult patient group with complex needs, which can be disruptive to family practices |
| A nurse practitioner’s perspective on prescribing suboxone for opioid use disorder |
(Moore, 2018) |
Nurse practitioner treating patients in clinic setting |
Opinion |
Allowing Nurse Practitioners (NP) and Physician Assistants to prescribe buprenorphine/naloxone has filled a treatment gap for patients with OUD In states where NP practice is limited, NPs must be supervised by a buprenorphine/naloxone waivered physician, which can be difficult to find 90% of waivered practitioners are in urban cities 44% of rural providers who treat OUD are not accepting new patients “When you require personal authorizations, you double the workload per patient.” |
| Caring for Ms. L -- overcoming my fear of treating opioid use disorder |
(Provenzano, 2018) |
Opinion piece by a physician about treating a woman with OUD |
Opinion |
Patient (Ms. L) wanted buprenorphine but Dr. Provenzano would not prescribe it:
Cited reasons for physician disinterest in buprenorphine waiver:
Too tired to do extra training / work Didn’t want to deal with the type of patients who would need buprenorphine Didn’t want to take on patients with needs that she did not know how to meet
Ms. L stopped showing up to this doctor after she was referred to another provider to get Buprenorphine
Ms. L overdoses and dies Dr. describes feeling shame regarding the “what if s” about if she had treated instead of referring?
|
|
|
|
|
|
| Treating patients with opioid use disorder |
(Lopes, 2019) |
Opinion |
Opinion |
PAs and NPs gaining the ability to write a buprenorphine prescription does not address the problem of limited access to care for patients Reasons for providers not prescribing buprenorphine to capacity include: lack of psychosocial support, time constraints, lack of confidence, resistance from practice partners, lack of patient need, and lack of institutional support |
| Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review |
(Louie, Assefa, & McGovern, 2019) |
Narrative review |
Not Applicable |
Providers were sometimes worried about the effectiveness of buprenorphine Providers were concerned about the cost of buprenorphine, since many insurance plans do not cover the medication Providers were worried about the “type” of patient buprenorphine treatment would attract Providers who did not prescribe buprenorphine were more likely to estimate lower efficacy of medication Providers mentioned how MOUD treatment was not taught in medical school |
