Format

Send to

Choose Destination
Am J Addict. 2013 May-Jun;22(3):285-91. doi: 10.1111/j.1521-0391.2012.12004.x.

Patient perspectives on choosing buprenorphine over methadone in an urban, equal-access system.

Author information

1
Friends Research Institute, 1040 Park Avenue, Baltimore, MD 21201, USA. jgryczynski@friendsresearch.org

Abstract

BACKGROUND:

Recent policy initiatives in Baltimore City, MD significantly reduced access disparities between methadone and buprenorphine in the publicly funded treatment sector.

OBJECTIVES:

This study examines reasons for choosing buprenorphine over methadone among patients with access to both medications.

METHOD:

This study was embedded within a larger clinical trial conducted at two outpatient substance abuse treatment programs offering buprenorphine. Qualitative and quantitative data on treatment choice were collected for new patients starting buprenorphine treatment (n = 80). The sample consisted of predominantly urban African American (94%) heroin users who had prior experience with non-prescribed street buprenorphine (85%), and opioid agonist treatment (68%). Qualitative data were transcribed and coded for themes, while quantitative data were analyzed using descriptive and bivariate statistics.

RESULTS:

Participants typically conveyed their choice of buprenorphine treatment as a decision against methadone. Buprenorphine was perceived as a helpful medication while methadone was perceived as a harmful narcotic with multiple unwanted physical effects. Positive experiences with non-prescribed "street buprenorphine" were a central factor in participants' decisions to seek buprenorphine treatment.

CONCLUSIONS:

Differences in service structure between methadone and buprenorphine did not strongly influence treatment-seeking decisions in this sample. Personal experiences with medications and the street narrative surrounding them play an important role in treatment selection decisions.

SCIENTIFIC SIGNIFICANCE:

This study characterizes important decision factors that underlie patients' selection of buprenorphine over methadone treatment.

PMID:
23617873
PMCID:
PMC4215541
DOI:
10.1111/j.1521-0391.2012.12004.x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center