Barriers to the implementation of medication-assisted treatment for substance use disorders: The importance of funding policies and medical infrastructure

Hannah K. Knudsen, Amanda J. Abraham, Carrie B. Oser

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

Despite growing interest in the use of evidence-based treatment practices, adoption of pharmacotherapies for treating substance use disorders (SUDs) remains modest. Using data from telephone interviews with 250 administrators of publicly funded SUD treatment programs, this study estimated a model of adoption of medication assisted treatment (MAT) for SUDs and examined the relative importance of regulatory, cultural, medical resource, patient-level, and funding barriers to MAT implementation. MAT-adopting programs had significantly greater medical resources, as measured by the employment of physicians and nurses, than non-adopting programs. Administrators of non-adopting programs were asked to rate the importance of 18 barriers to MAT implementation. The most strongly endorsed barriers were regulatory prohibitions due to the program's lack of medical staff, funding barriers to implementing MAT, and lack of access to medical personnel with expertise in delivering MAT. Barriers related to insufficient information about MAT and unsupportive staff attitudes were not widely endorsed. These findings suggest that efforts to promote the implementation of MAT that are inattentive to funding barriers and weaknesses in medical infrastructure may achieve sub-optimal results.

Original languageEnglish
Pages (from-to)375-381
Number of pages7
JournalEvaluation and Program Planning
Volume34
Issue number4
DOIs
StatePublished - Nov 2011

Bibliographical note

Funding Information:
The authors gratefully acknowledge research support from the Robert Wood Johnson Foundation's Substance Abuse Policy Research Program (Grant No. 65111 , PI: Dr. Hannah Knudsen) for supporting primary data collection and manuscript development. The sample of treatment programs was originally constructed through research support from the National Institute on Drug Abuse ( R01DA014482 , PI: Dr. Paul M. Roman, University of Georgia). Dr. Amanda Abraham received additional support from the National Institute on Alcohol Abuse and Alcoholism ( F32AA016872 ), and Dr. Carrie Oser received additional support from the National Institute on Drug Abuse ( K01DA021309 ). These sources of funding did not influence the design of the study, data collection, data analysis, or interpretation of the data. Opinions expressed are those of the authors and do not represent the official positions of the funding agencies.

Keywords

  • Barriers to implementation
  • Medication-assisted treatment
  • Treatment of substance use disorders

ASJC Scopus subject areas

  • Business and International Management
  • Social Psychology
  • Geography, Planning and Development
  • Strategy and Management
  • Public Health, Environmental and Occupational Health

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