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Current Psychiatry Reports
Erschienen in: Current Psychiatry Reports 5/2011

01.10.2011

Barriers to Use of Pharmacotherapy for Addiction Disorders and How to Overcome Them

verfasst von: Elizabeth M. Oliva, Natalya C. Maisel, Adam J. Gordon, Alex H. S. Harris

Erschienen in: Current Psychiatry Reports | Ausgabe 5/2011

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Abstract

Substance use disorders are highly prevalent, debilitating conditions for which effective pharmacotherapies exist with a broad evidence base, yet pharmacotherapy for the treatment of addiction disorders is underutilized. The goals of this review are to describe the barriers that may contribute to poor adoption and utilization of pharmacotherapy for alcohol and opioid dependence at the system, provider, and patient level and to discuss ways to overcome those barriers. Multifaceted efforts directed at all three levels may be needed to speed pharmacotherapy adoption. More research is needed to help us better understand barriers from patients’ perspectives. Strategies to promote adoption of pharmacotherapy for addiction disorders should be modified to fit the needs of the practice, system, and individual patients. Pharmacotherapy is a valuable tool in the clinical armamentarium of addiction treatment; thus, overcoming barriers to implementation may improve clinical and social outcomes.
Literatur
1.
Office of Applied Studies: Results from the 2009 National Survey on Drug Use and Health: Detailed Tables. 2009, Substance Abuse and Mental Health Services Administration: Rockville, MD.
2.
Office of National Drug Control Policy: The Economic Costs of Drug Abuse in the United States, 1992–2002. 2004, Executive Office of the President: Washington, DC.
3.
Rehm J, Mathers C, Popova S, et al. Alcohol and global health 1: Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009;373(9682):2223–33.PubMedCrossRef
4.
Harris AHS, Kivlahan DR, Bowe T, et al. Pharmacotherapy of alcohol use disorders in the Veterans Health Administration. Psychiatr Serv. 2010;61(4):392–8.PubMedCrossRef
5.
Knudsen HK, Abraham AJ, Roman PM. Adoption and implementation of medications in addiction treatment programs. J Addict Med. 2011;5(1):21–7.PubMedCrossRef
6.
Mark TL, Kranzler HR, Poole VH, et al. Alcohol and opioid dependence medications: prescription trends, overall and by physician specialty. Drug Alcohol Depend. 2009;99(1–3):345–9.PubMedCrossRef
7.
Substance Abuse and Mental Health Services Administration: The N-SSATS Report: Services Provided by Substance Abuse Treatment Facilities in the United States. Office of Applied Studies 2009: Rockville, MD.
8.
• Roman PM, Abraham AJ, Knudsen HK. Using medication-assisted treatment for substance use disorders: evidence of barriers and facilitators of implementation. Addict Behav. 2011;36:584–9. This article describes data obtained from recent US national surveys regarding pharmacotherapy for substance use disorders and discusses facilitators and barriers to pharmacotherapy adoption. PubMedCrossRef
9.
10.
Department of Veterans Affairs and Department of Defense: Management of Substance Use Disorders (SUD). Office of Quality and Performance, VA and Quality Management Office, United States Army MEDCOM 2009: Washington, DC.
11.
Soyka M, Kranzler HR, Berglund M, et al. World federation of societies of biological psychiatry (WFSBP) guidelines for biological treatment of substance use and related disorders, part 1: alcoholism. World J Biol Psychiatry. 2008;9(1):6–23.PubMedCrossRef
12.
Soyka M, Kranzler HR, van den Brink W, et al. World federation of societies of biological psychiatry (WFSBP) guidelines for biological treatment of substance use and related disorders, part 2: opioid dependence. World J Biol Psychiatry. 2011;12:160–87.PubMedCrossRef
13.
Boothby LA, Doering PL. Acamprosate for the treatment of alcohol dependence. Clin Ther. 2005;27(6):695–714.PubMedCrossRef
14.
Snyder JL, Bowers TG. The efficacy of acamprosate and naltrexone in the treatment of alcohol dependence: a relative benefits analysis of randomized controlled trials. Am J Drug Alcohol Abuse. 2008;34(4):449–61.PubMedCrossRef
15.
Streeton C, Whelan G. Naltrexone, a relapse prevention maintenance treatment of alcohol dependence: a meta-analysis of randomized controlled trials. Alcohol Alcohol. 2001;36(6):544–52.PubMed
16.
Bouza C, Angeles M, Munoz A, et al. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction. 2004;99(7):811–28.PubMedCrossRef
17.
Garbutt JC. Efficacy and tolerability of naltrexone in the management of alcohol dependence. Curr Pharm Des. 2010;16(19):2091–7.PubMedCrossRef
18.
Rösner S, Hackl-Herrwerth A, Leucht S, et al. Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev 2010, Issue 12. Art. No.: CD001867.
19.
Kranzler HR, Kirk J. Efficacy of naltrexone and acamprosate for alcoholism treatment: a meta analysis. Alcohol Clin Exp Res. 2001;25(9):1335–41.PubMedCrossRef
20.
Rösner S, Leucht S, Lehert P, et al. Acamprosate supports abstinence, naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes. J Psychopharmacol. 2008;22(1):11–23.PubMedCrossRef
21.
Rösner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev 2010, Issue 9. Art. No.: CD004332.
22.
Mattick R, Breen C, Kimber J, et al. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev 2009, Issue 3. Art. No.: CD002209.
23.
Mattick R, Kimber J, Breen C, et al. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev 2008, Issue 2. Art. No.: CD002207.
24.
Mattick RP, Ali R, White JM, et al. Buprenorphine versus methadone maintenance therapy: a randomized double blind trial with 405 opioid dependent patients. Addiction. 2003;98(4):441–52.PubMedCrossRef
25.
Barnett PG. Comparison of costs and utilization among buprenorphine and methadone patients. Addiction. 2009;104(6):982–92.PubMedCrossRef
26.
Barnett PG, Zaric GS, Brandeau ML. The cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States. Addiction. 2001;96(9):1267–78.PubMedCrossRef
27.
Connock M, Juarez-Garcia A, Jowett S, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess 2007, 11(9):iii–171.
28.
Fiellin DA, Rosenheck RA, Kosten TR. Office-based treatment for opioid dependence: reaching new patient populations. Am J Psychiatry. 2001;158(8):1200–4.PubMedCrossRef
29.
Sullivan LE, Fiellin DA. Narrative review: buprenorphine for opioid-dependent patients in office practice. Ann Intern Med. 2008;148(9):662–70.PubMed
30.
Becker WC, Fiellin DA, Merrill JO, et al. Opioid use disorder in the United States: insurance status and treatment access. Drug Alcohol Depend. 2008;94(1–3):207–13.PubMedCrossRef
31.
Ducharme LJ, Abraham AJ. State policy influence on the early diffusion of buprenorphine in community treatment programs. Subst Abuse Treat Prev Policy. 2008;3(1):17.PubMedCrossRef
32.
Finkelstein R, Netherland J, Sylla L, et al. Policy implications of integrating buprenorphine/naloxone treatment and HIV care. J Acquir Immune Defic Syndr. 2011;56:S98–S104.PubMedCrossRef
33.
Knudsen HK, Roman PM, Oser CB. Facilitating factors and barriers to the use of medications in publicly funded addiction treatment organizations. J Addict Med. 2010;4(2):99–107.PubMedCrossRef
34.
Lobmaier P, Gossop M, Waal H, et al. The pharmacological treatment of opioid addiction—a clinical perspective. Eur J Clin Pharmacol. 2010;66(6):537–45.PubMedCrossRef
35.
Mark TL, Kassed CA, Vandivort-Warren R, et al. Barriers to the use of medications to treat alcoholism. Am J Addict. 2003;12(4):281–94.PubMed
36.
Rieckmann T, Kovas AE, Rutkowski BA. Adoption of medications in substance abuse treatment: priorities and strategies of single state authorities. J Psychoactive Drugs. 2010;Supplement 6:227–38.
37.
Thomas CP, Wallack SS, Lee S, et al. Research to practice: adoption of naltrexone in alcoholism treatment. J Subst Abuse Treat. 2003;24(1):1–11.PubMedCrossRef
38.
• Weber EM. Failure of physicians to prescribe pharmacotherapies for addiction: regulatory restrictions and physician resistance. J Health Care Law Policy 2010;13:49–76. This article provides a good historical overview of factors contributing to low utilization of pharmacotherapies for addiction.
39.
Horgan CM, Reif S, Hodgkin D, et al. Availability of addiction medications in private health plans. J Subst Abuse Treat. 2008;34(2):147–56.PubMedCrossRef
40.
Knudsen HK, Abraham AJ, Johnson JA, et al. Buprenorphine adoption in the National Drug Abuse Treatment Clinical Trials Network. J Subst Abuse Treat. 2009;37(3):307–12.PubMedCrossRef
41.
Knudsen HK, Ducharme LJ, Roman PM. The adoption of medications in substance abuse treatment: associations with organizational characteristics and technology clusters. Drug Alcohol Depend. 2007;87(2–3):164–74.PubMedCrossRef
42.
Stöver H. Barriers to opioid substitution treatment access, entry and retention: a survey of opioid users, patients in treatment, and treating and non-treating physicians. Eur Addict Res. 2011;17(1):44–54.PubMedCrossRef
43.
Walley AY, Alperen JK, Cheng DM, et al. Office-based management of opioid dependence with buprenorphine: clinical practices and barriers. J Gen Intern Med. 2008;23(9):1393–8.PubMedCrossRef
44.
Netherland J, Botsko M, Egan JE, et al. Factors affecting willingness to provide buprenorphine treatment. J Subst Abuse Treat. 2009;36(3):244–51.PubMedCrossRef
45.
Heinrich CJ, Hill CJ. Role of state policies in the adoption of naltrexone for substance abuse treatment. Health Serv Res. 2008;43(3):951–70.PubMedCrossRef
46.
Albright J, Ciaverelli R, Essex A, et al. Psychiatrist characteristics that influence use of buprenorphine medication-assisted treatment. J Addict Med. 2010;4(4):197–203.PubMedCrossRef
47.
Humphreys K, Trafton JA, Oliva EM. Does following research-derived practice guidelines improve opiate-dependent patients’ outcomes under everyday practice conditions?: results of the multisite opiate substitution treatment study. J Subst Abuse Treat. 2008;34(2):173–9.PubMedCrossRef
48.
Abraham AJ, Ducharme LJ, Roman PM. Counselor attitudes toward pharmacotherapies for alcohol dependence. J Stud Alcohol Drugs. 2009;70(4):628–35.PubMed
49.
Bacha J, Reast S, Pearlstone A. Treatment practices and perceived challenges for European physicians treating opioid dependence. Heroin Addict Relat Clin Probl. 2010;12(3):9–19.
50.
Barry DT, Irwin KS, Jones ES, et al. Integrating buprenorphine treatment into office-based practice: a qualitative study. J Gen Intern Med. 2009;24(2):218–25.PubMedCrossRef
51.
Drake R, Skinner J, Goldman HH. What explains the diffusion of treatments for mental illness? Am J Psychiatry. 2008;165(11):1385–92.PubMedCrossRef
52.
Wallack SS, Thomas CP, Martin TC, et al. Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a Congressionally approved medication. J Behav Health Serv Res. 2010;37(1):64–78.PubMedCrossRef
53.
Gordon A, Kavanagh G, Krumm M, et al. Facilitators and barriers in implementing buprenorphine in the Veterans Health Administration. Psychol Addict Behav. 2011;25(2):215–24.
54.
Fitzgerald J, McCarty D. Understanding attitudes toward use of medication in substance abuse treatment: a multilevel approach. Psychol Serv. 2009;6(1):74–84.PubMedCrossRef
55.
Lundgren L, Krull I, Zerden LS, et al. Community based addiction treatment staff attitudes about the usefulness of evidence-based addiction treatment and CBO organizational linkages to research institutions. Eval Program Plann. 2011;34(4):356–65.
56.
Dackis C, O’Brien C. Neurobiology of addiction: treatment and public policy ramifications. Nat Neurosci. 2005;8(11):1431–6.PubMedCrossRef
57.
Littleton JM, de Witte P, Litten R, et al. Challenges to medications development in treating alcohol dependence: an international perspective. Alcohol Alcohol. 2004;39(4):271–5.PubMed
58.
Center for Substance Abuse Treatment: Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series 49. Substance Abuse and Mental Health Services Administration 2009: Rockville, MD.
59.
McAuley K, Maurice D, Ferguson A, et al. Evaluation of the impact of medication assisted treatment in Maine. Department of Health and Human Services, Maine Office of Substance Abuse. South Portland: Hornby Zeller Associates, Inc.; 2010.
60.
McCarty D, Perrin NA, Green CA, et al. Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan. Drug Alcohol Depend. 2010;111(3):235–40.PubMedCrossRef
61.
Fornili K, Burda C. Buprenorphine prescribing: why physicians aren’t and nurse prescribers can’t. J Addict Nurs. 2009;20(4):218–26.CrossRef
62.
Cunningham CO, Sohler NL, McCoy K, et al. Attending physicians’ and residents’ attitudes and beliefs about prescribing buprenorphine at an urban teaching hospital. Fam Med. 2006;38(5):336–40.PubMed
63.
Thomas SE, Miller PM. Knowledge and attitudes about pharmacotherapy for alcoholism: a survey of counselors and administrators in community-based addiction treatment centres. Alcohol Alcohol. 2007;42(2):113–8.PubMed
64.
O’Connor PG, Nyquist JG, McLellan AT. Integrating addiction medicine into graduate medical education in primary care: the time has come. Ann Intern Med. 2011;154(1):56–9.PubMed
65.
Martino S, Brigham GS, Higgins C, et al. Partnerships and pathways of dissemination: The National Institute on Drug Abuse--Substance Abuse and Mental Health Services Administration Blending Initiative in the Clinical Trials Network. J Subst Abuse Treat. 2010;38(Supplement 1):S31–43.PubMedCrossRef
66.
Gordon AJ, Liberto J, Granda S, et al. Outcomes of DATA 2000 certification trainings for the provision of buprenorphine treatment in the Veterans Health Administration. Am J Addict. 2008;17(6):459–62.PubMedCrossRef
67.
Gordon AJ, Liberto J, Granda S, et al. Physician training is never a failure. Am J Addict. 2009;18(4):337–8.CrossRef
68.
Anton RF, O’Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295(17):2003–17.PubMedCrossRef
69.
West JC, Kosten TR, Wilk J, et al. Challenges in increasing access to buprenorphine treatment for opiate addiction. Am J Addict. 2004;13(S1):S8–S16.PubMedCrossRef
70.
Ridge G, Gossop M, Lintzeris N, et al. Factors associated with the prescribing of buprenorphine or methadone for treatment of opiate dependence. J Subst Abuse Treat. 2009;37(1):95–100.PubMedCrossRef
71.
Cunningham CO, Kunins HV, Roose RJ, et al. Barriers to obtaining waivers to prescribe buprenorphine for opioid addiction treatment among HIV physicians. J Gen Intern Med. 2007;22(9):1325–9.PubMedCrossRef
72.
Turner BJ, Laine C, Lin Y, et al. Barriers and facilitators to primary care or human immunodeficiency virus clinics providing methadone or buprenorphine for the management of opioid dependence. Arch Intern Med. 2005;165(15):1769–76.PubMedCrossRef
73.
Strobbe S, Mathias L, Gibbons PW, et al. Buprenorphine clinic for opioid maintenance therapy: program description, process measures, and patient satisfaction. J Addict Nurs. 2011;22:8–12.CrossRef
74.
Egan JE, Casadonte P, Gartenmann T, et al. The physician clinical support system-buprenorphine (PCSS-B): a novel project to expand/improve buprenorphine treatment. J Gen Intern Med. 2010;25(9):936–41.PubMedCrossRef
75.
Abraham AJ, Rieckmann T, McNulty T, et al. Counselor attitudes toward the use of naltrexone in substance abuse treatment: a multi-level modeling approach. Addict Behav. 2011;36(6):576–83.PubMedCrossRef
76.
Kahan M, Srivastava A, Ordean A, et al. Buprenorphine: new treatment of opioid addiction in primary care. Can Fam Physician. 2011;57(3):281–9.PubMed
Metadaten
Titel
Barriers to Use of Pharmacotherapy for Addiction Disorders and How to Overcome Them
verfasst von
Elizabeth M. Oliva
Natalya C. Maisel
Adam J. Gordon
Alex H. S. Harris
Publikationsdatum
01.10.2011
Verlag
Current Science Inc.
Erschienen in
Current Psychiatry Reports / Ausgabe 5/2011
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-011-0222-2

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