Understanding attitudes towards use of medication in substance abuse treatment: A multilevel approach.

Individual and organizational variables influence attitudes towards use of naltrexone, methadone, and buprenorphine for the treatment of alcohol and drug disorders. Prior research has not considered both sets of influences simultaneously. Hierarchical linear modeling tested the contribution of individual and organizational variables using data from the National Drug Abuse Treatment Clinical Trials Network treatment unit and workforce surveys (n = 2,269 staff nested within 247 treatment units). Individual-level variables consistently had more influence on attitudes, but a unique blend of variables existed for each medication. One predictor, support for psychiatric medications, influenced attitudes across all medications. Staff attitudes towards addiction medications varied significantly between treatment units. Implications for increasing the appropriate use of addiction medications are discussed.