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Addict Behav. 2019 Jun;93:72-77. doi: 10.1016/j.addbeh.2019.01.023. Epub 2019 Jan 16.

Perceived need and availability of psychosocial interventions across buprenorphine prescriber specialties.

Author information

1
Addiction Center, Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, United States; Center for Clinical Management Research (CCMR), Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI 48109, United States. Electronic address: leweil@med.umich.edu.
2
University of Kentucky, Department of Behavioral Science and Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, United States.

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.

KEYWORDS:

Buprenorphine; Counseling; Opioid use disorder; Providers; Psychosocial

PMID:
30690416
PMCID:
PMC6488400
[Available on 2020-06-01]
DOI:
10.1016/j.addbeh.2019.01.023

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