Attitudes Toward Evidence-Based Pharmacological Treatments Among Community-Based Addiction Treatment Programs Targeting Vulnerable Patient Groups

Abstract

A national sample of addiction treatment Program Directors (N = 296) were assessed regarding their attitudes about pharmacological treatment for addiction disorders. Multivariable analyses indicate that directors who worked in organizations affiliated with research institutions and who had more professional experience had significantly more positive attitudes about a range of pharmacological therapies. Also, directors in organizations serving higher percentage homeless clients and clients with severe and persistent mental illness had more negative attitudes toward use of buprenorphine. Community-based organizations providing addiction treatment to specific vulnerable client groups exhibit more negative attitudes about pharmacological evidence-based practices and may underutilize those practices.

How do third sector organisations use research and other knowledge? A systematic scoping review

“…Secondly, we also deliberated whether studies of variation in the uptake of “evidence-based practices” should be regarded as knowledge mobilisation research. We took the view that, even if a study explicitly labelled particular practices as evidence-based, then a study which only investigated attitudes towards those treatments [ 27 ] or variations in uptake was not strictly knowledge mobilisation research. It would only be knowledge mobilisation research, we decided, if there was some investigation into the processes of uptake of the practice or if there was an explicit initiative to promote the implementation of the evidence-based practice (e.g.…”

Office-Based Addiction Treatment Retention and Mortality Among People Experiencing Homelessness

“…5 However, there are several barriers that prevent homeless individuals from receiving this evidencebased treatment, including fragmented and stigmatizing medical care, especially around episodes of incarceration, and the unfounded belief that treatment is unsuccessful in people who lack stable housing. [6][7][8][9][10] To overcome these barriers, innovative methods, such as provision of medications for OUD within harm reduction agencies, mobile methadone vans, and buprenorphine prescribing by street medicine teams, have been deployed and demonstrate the ability to reach larger populations of homeless and unstably housed patients. 9,[11][12][13] Because brick-and-mortar clinics may be more sustainable, there has been increased interest in developing office-based addiction treatment (OBAT) programs specifically for people experiencing homelessness.…”

Buprenorphine Maintenance for Opioid Dependence in Public Sector Healthcare: Benefits and Barriers

“…Some physicians report concern about deception, suspicion of patient reported withdrawal symptoms [ 27 ], or worry that such patients would be disproportionately late to appointments [ 22 ]. Negative provider attitudes can also affect buprenorphine treatment rates; Krull et al [ 28 ] found that directors of addiction treatment programs serving homeless patients generally had negative attitudes towards buprenorphine use, indicating a need for education of public service providers about the clinically efficacy of buprenorphine.…”

“…No significant differences in retention rates were found due to age, ethnicity, employment, or housing status. In a separate study of homeless patients, buprenorphine treatment was also associated with obtaining housing [ 28 ].…”