Perceptions of medications, program settings, and drug use histories among individuals engaged in treatment for opioid use disorder

Abstract

Background: Nearly two million adults in the US currently live with an Opioid Use Disorder (OUD) diagnosis. Recent efforts have encouraged and facilitated widespread adoption of empirically supported medications for opioid use disorder (MOUD), yet MOUD and OUD behavioral health interventions remain dramatically underutilized. Fear of discrimination and judgment, compounded by systemic and regulatory barriers, hinder individuals’ access to specialty treatment.Objectives: The goal of the current study was to (1) reveal how perspectives toward OUD treatment may differ across medication types, program settings, and drug use history; (2) address systemic and regulatory components that potentially foster and propagate positive or negative attributions to OUD; and (3) understand how experiences reduce patients’ willingness to pursue and/or maintain long term treatment.Methods: Twenty-four adults engaged in buprenorphine treatment at two outpatient addiction treatment centers participated in in-depth, qualitative interviews between 2019 and 2020 in Providence, Rhode Island.Results: Thematic analysis revealed negative attributions toward OUD across all participants. Three key themes developed from the coding and analysis: (1) differential perceptions of therapeutic medications (2) negative perceptions of treatment programs and (3) perceptions of drugs and people who use drugs.Conclusions: Stigmatizing language remains a major public health issue that needs to be addressed to facilitate treatment for individuals for OUD and other drug use disorders. Incorporating strategies targeting labeling across medication types, program settings, and drug use may improve treatment outcomes by reducing the inaccurate beliefs surrounding OUD and connecting patients to evidence-based support.

Keywords:

• Language
• OUD
• MOUD
• labeling
• adults

Acknowledgements

The authors acknowledge the Qualitative Science & Methods Training Program (QSMTP) of the Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, which provided training in qualitative research methods for this manuscript.

Authors’ contributions

KJL is the Principal Investigator for the study and led the conceptualization of the study and the drafting of the original grant proposal. SR, KBC, MLR, and JR are mentors and contributed to the writing of the original grant proposal. CS is the senior research assistant, developed a first draft of the manuscript, and contributed to successive drafts. PJ is the research assistant and contributed to successive drafts of the manuscript. SR, KC, MLR, SC, JR, and KJL contributed to successive drafts and approved the final manuscript.

Disclosure statement

Dr. Susan Ramsey has an Investigator Sponsored Research Agreement with Gilead Science, Inc. for the provision of medication for another trial.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number K23DA046482. Drs. Rich, Ramsey, Ranney, and Langdon are all supported, in part by a National Institute of General Medical Studies Grant (P20 GM125507).