Perceived need and availability of psychosocial interventions across buprenorphine prescriber specialties

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10 Scopus citations

Abstract

Introduction: Psychosocial interventions are often recommended as part of buprenorphine treatment for patients with opioid use disorder, but little is known about prescriber perspectives on their use and how this varies across buprenorphine prescriber specialties. Methods: A large US sample of physicians actively prescribing buprenorphine (n = 1174) was surveyed from July 2014 to January 2017. Analyses examined prescriber characteristics and their perceptions and use of psychosocial interventions across three groups of physicians: primary care providers (PCPs), addiction physicians/psychiatrists, and other physicians. Results: Across all prescribers, 93.3% (n = 1061) report most patients would benefit from formal counseling during buprenorphine treatment while only 36.4% (n = 414) believe there are adequate number of counselors in their communities. Among addiction physicians/psychiatrists, 75.9% (n = 416) report their treatment settings have the resources to provide psychiatric services to patients with complex psychiatric problems compared to 29.1% (n = 130) of PCPs and 29.6% (n = 39, p <.001) of other physicians. Addiction physicians/psychiatrists report a higher percentage of patients receive counseling from clinicians in their practice while PCPs report a higher percentage of patients receive counseling from external providers. Conclusions: The majority of prescribers believe patients receiving buprenorphine would benefit from psychosocial interventions and there is variation in how these services are delivered. However, many prescribers, especially those without addiction or psychiatry backgrounds, report their settings do not have adequate psychosocial treatment resources for patients with complex psychosocial needs. Future work developing novel models of psychosocial interventions may be helpful to support prescribers to effectively treat complex patients with opioid use disorders.

Original languageEnglish
Pages (from-to)72-77
Number of pages6
JournalAddictive Behaviors
Volume93
DOIs
StatePublished - Jun 2019

Bibliographical note

Funding Information:
Lewei Lin and Hannah Knudsen have no conflicts of interest. Michelle Lofwall has received contract research funding from Braeburn Pharmaceuticals, has consulted for Indivior and CVS Caremark, and has received honoraria from PCM Scientific (which received unrestricted educational grant funds from Reckitt Benckiser) for developing and presenting educational materials on opioid use disorder. Related to buprenorphine for opioid use disorder, Dr. Walsh has received research funding, consulting fees, and travel support from Braeburn and Camurus as well as travel support and honoraria from Indivior. She has also received consulting fees from Lilly, Inc., Pfizer, Brainsway, KemPharm, World Meds, INSYS and Daiichi-Sankyo in the last three years.

Funding Information:
This research was supported by a grant from the National Institute on Drug Abuse (NIDA Grant R33DA035641). Use of REDCap was supported by an award from NIH's National Center for Advancing Translational Sciences (NIH CTSA UL1TR000117). The authors are solely responsible for this manuscript, which does not represent the official views of NIH, NCATS, or NIDA. The funding sources had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Publisher Copyright:
© 2019 Elsevier Ltd

Keywords

  • Buprenorphine
  • Counseling
  • Opioid use disorder
  • Providers
  • Psychosocial

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Toxicology
  • Psychiatry and Mental health

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