The American journal on addictions · 2013
Patient perspectives on choosing buprenorphine over methadone in an urban, equal-access system.
Клиническое исследованиеСтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Gryczynski Jan, Jaffe Jerome H, Schwartz Robert P, Dušek Kristi A, Gugsa Nishan, Monroe Cristin L, O'Grady Kevin E, Olsen Yngvild K, Mitchell Shannon Gwin
Аннотация
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.
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.