Kai MacDonald1,2, Kristy Lamb1,2,3, Michael L Thomas1, Wendy Khentigan4. 1. a Department of Psychiatry , UCSD School of Medicine , La Jolla , California , USA. 2. b Department of Family Medicine and Public Health , UCSD School of Medicine , La Jolla , California , USA. 3. c BOLD Health, Inc. , San Diego , California , USA. 4. d Private Practice , Encinitas , California , USA.
Abstract
BACKGROUND: Despite the existence of evidence-based guidelines, different prescriber practices around buprenorphine maintenance treatment (BMT) of opiate dependence exist. Moreover, certain prescriber beliefs may influence their practice patterns. OBJECTIVE: To understand community BMT practice patterns and discern their relationship to practitioner beliefs. METHOD: Survey of 30 local BMT prescribers about aspects of BMT, and analysis of correlations between practices and practitioner beliefs. RESULTS: Practitioners generally followed standard treatment guidelines, though the most-common maintenance dosages of BMT (4-12 mg) were lower than recommended by some studies. Endorsement of belief in a "spiritual basis" of addiction correlated with lower average BMT doses and less frequent endorsement of the belief that BMT-treated patients are "in recovery." CONCLUSIONS/IMPORTANCE: These data suggest that relatively standardized, longer-term BMT of opiate dependence is accepted among the majority of surveyed prescribers, and certain provider beliefs about addiction may influence prescribing habits and attitudes. Future studies should: (1) assess these findings in larger samples; (2) examine how prescriber beliefs about addiction and BMT compare with those of other addiction treatment providers; and (3) ascertain whether individual prescriber beliefs influence patient outcomes.
BACKGROUND: Despite the existence of evidence-based guidelines, different prescriber practices around buprenorphine maintenance treatment (BMT) of opiate dependence exist. Moreover, certain prescriber beliefs may influence their practice patterns. OBJECTIVE: To understand community BMT practice patterns and discern their relationship to practitioner beliefs. METHOD: Survey of 30 local BMT prescribers about aspects of BMT, and analysis of correlations between practices and practitioner beliefs. RESULTS: Practitioners generally followed standard treatment guidelines, though the most-common maintenance dosages of BMT (4-12 mg) were lower than recommended by some studies. Endorsement of belief in a "spiritual basis" of addiction correlated with lower average BMT doses and less frequent endorsement of the belief that BMT-treated patients are "in recovery." CONCLUSIONS/IMPORTANCE: These data suggest that relatively standardized, longer-term BMT of opiate dependence is accepted among the majority of surveyed prescribers, and certain provider beliefs about addiction may influence prescribing habits and attitudes. Future studies should: (1) assess these findings in larger samples; (2) examine how prescriber beliefs about addiction and BMT compare with those of other addiction treatment providers; and (3) ascertain whether individual prescriber beliefs influence patient outcomes.
Authors: Felipe Castillo; Daniel Scalise; David Hernandez; Rahul Gupta; Cale N Basaraba; Thomas Corbeil; Sandra D Comer; Andres R Schneeberger Journal: J Addict Dis Date: 2022-04-22
Authors: Hannah K Knudsen; Michelle R Lofwall; Lewei Allison Lin; Sharon L Walsh; Jamie L Studts Journal: Drug Alcohol Depend Date: 2019-08-30 Impact factor: 4.852