Skip to main content
Top
Published in: The Journal of Behavioral Health Services & Research 3/2010

01-07-2010

Top Manager Effects on Buprenorphine Adoption in Outpatient Substance Abuse Treatment Programs

Authors: Peter D. Friedmann, MD, MPH, Lan Jiang, MS, Jeffrey A. Alexander, PhD

Published in: The Journal of Behavioral Health Services & Research | Issue 3/2010

Login to get access

Abstract

To examine the influence of top managers’ characteristics on the adoption of buprenorphine for opioid dependence among U.S. outpatient substance abuse treatment units, this investigation analyzed a cross-sectional national study of 547 such units in the 2004–2005 wave of the Drug Abuse Treatment System Survey. Administrators reported their demographics, training, and treatment orientation, as well as features of the unit and its pattern of use of buprenorphine. Nationally, 15.8% of programs offered any buprenorphine services. Greater adoption of buprenorphine correlated with directors’ younger age, longer tenure, male gender, and weaker endorsement of abstinence as the most important treatment goal. Availability of naltrexone and medical services also correlated positively with buprenorphine adoption. The authors conclude that leaders’ characteristics are related to the adoption of innovative practices in addiction treatment programs. Future work should examine whether leadership development for community addiction programs might speed up the diffusion of buprenorphine and other innovative, evidence-based practices.
Literature
1.
go back to reference Kakko J, Gronbladh L, Svanborg KD, et al. A stepped care strategy using buprenorphine and methadone versus conventional methadone maintenance in heroin dependence: a randomized controlled trial. American Journal of Psychiatry. 2007;164(5):797–803. doi:10.1176/appi.ajp.164.5.797.CrossRefPubMed Kakko J, Gronbladh L, Svanborg KD, et al. A stepped care strategy using buprenorphine and methadone versus conventional methadone maintenance in heroin dependence: a randomized controlled trial. American Journal of Psychiatry. 2007;164(5):797–803. doi:10.​1176/​appi.​ajp.​164.​5.​797.CrossRefPubMed
2.
go back to reference Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience. 2007;9(4):455–470.PubMed Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience. 2007;9(4):455–470.PubMed
3.
go back to reference Stein MD, Friedmann PD. Optimizing opioid detoxification: rearranging deck chairs on the Titanic. Journal of Addictive Diseases. 2007;26(2):1–2.CrossRefPubMed Stein MD, Friedmann PD. Optimizing opioid detoxification: rearranging deck chairs on the Titanic. Journal of Addictive Diseases. 2007;26(2):1–2.CrossRefPubMed
4.
go back to reference Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews. 2002;(4):CD002209. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews. 2002;(4):CD002209.
5.
16.
go back to reference Miller D, Kets De Vries M, Toulouse J. Top executive’s locus of control and its relation to strategy making, structure and environment. Academy of Management Journal. 1982;25:237–253. doi:10.2307/255988.CrossRef Miller D, Kets De Vries M, Toulouse J. Top executive’s locus of control and its relation to strategy making, structure and environment. Academy of Management Journal. 1982;25:237–253. doi:10.​2307/​255988.CrossRef
17.
go back to reference Hambrick DC, Mason PA. Upper echelons: the organization as a reflection of its top managers. Academy of Management Review. 1984;9:193–206. doi:10.2307/258434.CrossRef Hambrick DC, Mason PA. Upper echelons: the organization as a reflection of its top managers. Academy of Management Review. 1984;9:193–206. doi:10.​2307/​258434.CrossRef
19.
go back to reference Levinthal DA. Organizational adaptation, environmental selections and random walks. In: Singh JV, ed. Organizational Evolutions: New Directions. Newbury Park, CA: Sage; 1990:201–223. Levinthal DA. Organizational adaptation, environmental selections and random walks. In: Singh JV, ed. Organizational Evolutions: New Directions. Newbury Park, CA: Sage; 1990:201–223.
21.
22.
go back to reference Mintzberg H. The Structuring of Organizations: A Synthesis of the Research. Englewood Cliffs, NJ: Prentice Hall; 1979. Mintzberg H. The Structuring of Organizations: A Synthesis of the Research. Englewood Cliffs, NJ: Prentice Hall; 1979.
24.
go back to reference Kanter RM. Men and Women of the Corporation. New York: Basic Books; 1977. Kanter RM. Men and Women of the Corporation. New York: Basic Books; 1977.
25.
go back to reference Young GJ, Charns MP, Shortell SM. Top manager and network effects on the adoption of innovative management practices: a study of TQM in a public hospital system. Strategic Management Journal. 2001;22:935–951. doi:10.1002/smj.194.CrossRef Young GJ, Charns MP, Shortell SM. Top manager and network effects on the adoption of innovative management practices: a study of TQM in a public hospital system. Strategic Management Journal. 2001;22:935–951. doi:10.​1002/​smj.​194.CrossRef
26.
go back to reference Bradley EH, Webster TR, Baker D, et al. Translating research into practice: speeding the adoption of innovative health care programs. Commonwealth Fund Issue Brief. 2004;724:1–12. Bradley EH, Webster TR, Baker D, et al. Translating research into practice: speeding the adoption of innovative health care programs. Commonwealth Fund Issue Brief. 2004;724:1–12.
27.
go back to reference Bandura A. Personal and collective efficacy in human adaptation and change. In: Adair JG, Belanger D, Dion KL, eds. Advances in Psychological Science: Social, Personal and Cultural Aspects. Montreal: Psychology Press; 1996. Bandura A. Personal and collective efficacy in human adaptation and change. In: Adair JG, Belanger D, Dion KL, eds. Advances in Psychological Science: Social, Personal and Cultural Aspects. Montreal: Psychology Press; 1996.
28.
go back to reference Wells R, Lemak CH, D’Aunno TA. Insights from a national survey into why substance abuse treatment units add prevention and outreach services. Substance Abuse Treatment, Prevention and Policy. 2006;1(1):21. doi:10.1186/1747-597X-1-21.CrossRef Wells R, Lemak CH, D’Aunno TA. Insights from a national survey into why substance abuse treatment units add prevention and outreach services. Substance Abuse Treatment, Prevention and Policy. 2006;1(1):21. doi:10.​1186/​1747-597X-1-21.CrossRef
30.
go back to reference Kimberly JR, Evanisko MJ. Organizational innovation: the influence of individual, organizational and contextual factors on hospital adoption of technological and administrative innovations. Academy of Management Journal. 1981;24(4):689–713. doi:10.2307/256170.CrossRefPubMed Kimberly JR, Evanisko MJ. Organizational innovation: the influence of individual, organizational and contextual factors on hospital adoption of technological and administrative innovations. Academy of Management Journal. 1981;24(4):689–713. doi:10.​2307/​256170.CrossRefPubMed
31.
go back to reference Meyer AD, Goes JB. Organizational assimilation of innovations: a multilevel contextual analysis. Academy of Management Journal. 1988;31(4):897–923. doi:10.2307/256344.CrossRef Meyer AD, Goes JB. Organizational assimilation of innovations: a multilevel contextual analysis. Academy of Management Journal. 1988;31(4):897–923. doi:10.​2307/​256344.CrossRef
32.
go back to reference Arndt M, Bigelow B. The adoption of corporate restructuring by hospitals. Hospital and Health Services Administration. 1995;40(3):332–347. Arndt M, Bigelow B. The adoption of corporate restructuring by hospitals. Hospital and Health Services Administration. 1995;40(3):332–347.
34.
go back to reference Boeker W. Strategic change: the influence of managerial characteristics and organizational growth. Academy of Management Journal. 1997;40:152–170. doi:10.2307/257024.CrossRef Boeker W. Strategic change: the influence of managerial characteristics and organizational growth. Academy of Management Journal. 1997;40:152–170. doi:10.​2307/​257024.CrossRef
35.
39.
go back to reference Berger J, Zelditch M, eds. Status, Rewards, and Influence. How Expectations Organize Behavior. Washington, DC: Jossey-Bass; 1985. Berger J, Zelditch M, eds. Status, Rewards, and Influence. How Expectations Organize Behavior. Washington, DC: Jossey-Bass; 1985.
40.
41.
43.
go back to reference Damanpour F. Organizational innovation: a meta-analysis of effects of determinants and moderators. Academy of Management Journal. 1991;34:555–590. doi:10.2307/256406.CrossRef Damanpour F. Organizational innovation: a meta-analysis of effects of determinants and moderators. Academy of Management Journal. 1991;34:555–590. doi:10.​2307/​256406.CrossRef
44.
go back to reference Fiol CM. Squeezing harder doesn’t always work: continuing the search for consistency in innovation research. Academy of Management Review. 1996;21(4):1012–1021. Fiol CM. Squeezing harder doesn’t always work: continuing the search for consistency in innovation research. Academy of Management Review. 1996;21(4):1012–1021.
45.
47.
go back to reference McCaughrin WC, Price RH. Effective outpatient drug treatment organizations: program features and selection effects. International Journal of the Addictions. 1992;27:1335–1358.PubMed McCaughrin WC, Price RH. Effective outpatient drug treatment organizations: program features and selection effects. International Journal of the Addictions. 1992;27:1335–1358.PubMed
48.
go back to reference D’Aunno TA. Linking substance abuse treatment and primary health care. In: Egertson JA, Fox DM, Leshner AI, eds. Treating Drug Abusers Effectively. Malden, MA: Blackwell Publishers; 1997:311–351. D’Aunno TA. Linking substance abuse treatment and primary health care. In: Egertson JA, Fox DM, Leshner AI, eds. Treating Drug Abusers Effectively. Malden, MA: Blackwell Publishers; 1997:311–351.
49.
go back to reference Thompson J. Organizations in Action. New York: McGraw-Hill; 1967. Thompson J. Organizations in Action. New York: McGraw-Hill; 1967.
51.
52.
go back to reference D’Aunno T, Vaughn TE, McElroy P. An institutional analysis of HIV prevention efforts by the nation’s outpatient drug abuse treatment units. Journal of Health and Social Behavior. 1999;40(2):175–192. doi:10.2307/2676372.CrossRefPubMed D’Aunno T, Vaughn TE, McElroy P. An institutional analysis of HIV prevention efforts by the nation’s outpatient drug abuse treatment units. Journal of Health and Social Behavior. 1999;40(2):175–192. doi:10.​2307/​2676372.CrossRefPubMed
56.
go back to reference Center for Substance Abuse Treatment. Changing the Conversation: Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2000. Center for Substance Abuse Treatment. Changing the Conversation: Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2000.
57.
go back to reference Camison-Zornoza C, Boronat-Navarro M, Segarra-Cipres M. A meta-analysis of organizational innovation: moderator effects and internal and market variables. In: Saee J, ed. Contemporary Corporate Strategy. London: Global Perspectives; 2007. Camison-Zornoza C, Boronat-Navarro M, Segarra-Cipres M. A meta-analysis of organizational innovation: moderator effects and internal and market variables. In: Saee J, ed. Contemporary Corporate Strategy. London: Global Perspectives; 2007.
59.
go back to reference Weil P, Kimball P. Gender and compensation in health care management. Health Care Management Review. 1996;21(3):19–33.PubMed Weil P, Kimball P. Gender and compensation in health care management. Health Care Management Review. 1996;21(3):19–33.PubMed
61.
go back to reference Jaskyte K. Transformational leadership, organizational culture and innovativeness in nonprofit organizations. Nonprofit Management & Leadership. 2004;15:153–167. doi:10.1002/nml.59.CrossRef Jaskyte K. Transformational leadership, organizational culture and innovativeness in nonprofit organizations. Nonprofit Management & Leadership. 2004;15:153–167. doi:10.​1002/​nml.​59.CrossRef
62.
go back to reference Batten HL, Horgan CH, Prottas JM, et al. Drug Services Research Survey. Phase I Final Report: Non-Correctional Facilities. Waltham, MA: Brandeis University Institute for Health Policy; 1993. Batten HL, Horgan CH, Prottas JM, et al. Drug Services Research Survey. Phase I Final Report: Non-Correctional Facilities. Waltham, MA: Brandeis University Institute for Health Policy; 1993.
63.
go back to reference Lawrence BS. The black box of organizational demography. Organization Science. 1997;8(1):1–22.CrossRef Lawrence BS. The black box of organizational demography. Organization Science. 1997;8(1):1–22.CrossRef
64.
go back to reference Amass L, Ling W, Freese TE, et al. Bringing buprenorphine–naloxone detoxification to community treatment providers: the NIDA Clinical Trials Network field experience. American Journal of Addiction. 2004;13(Suppl 1):S42–S66. doi:10.1080/10550490490440807.CrossRef Amass L, Ling W, Freese TE, et al. Bringing buprenorphine–naloxone detoxification to community treatment providers: the NIDA Clinical Trials Network field experience. American Journal of Addiction. 2004;13(Suppl 1):S42–S66. doi:10.​1080/​1055049049044080​7.CrossRef
65.
go back to reference D’Aunno TA, Sutton RI, Price RH. Isomorphism and external support in conflicting institutional environments: a study of drug abuse treatment units. Academy of Management Journal. 1991;34:636–661. doi:10.2307/256409.CrossRefPubMed D’Aunno TA, Sutton RI, Price RH. Isomorphism and external support in conflicting institutional environments: a study of drug abuse treatment units. Academy of Management Journal. 1991;34:636–661. doi:10.​2307/​256409.CrossRefPubMed
66.
go back to reference D’Aunno TA, Alexander JA, Succi M. The role of institutional and market factors in divergent organizational change. Administrative Science Quarterly. 2000;45(4):679–703. doi:10.2307/2667016.CrossRef D’Aunno TA, Alexander JA, Succi M. The role of institutional and market factors in divergent organizational change. Administrative Science Quarterly. 2000;45(4):679–703. doi:10.​2307/​2667016.CrossRef
67.
go back to reference Hasenfeld Y. Human Service Organizations. Englewood Cliffs, NJ: Prentice Hall; 1983. Hasenfeld Y. Human Service Organizations. Englewood Cliffs, NJ: Prentice Hall; 1983.
68.
go back to reference Hoge MA, Morris JA, Daniels AS, et al. Report of recommendations: the Annapolis Coalition Conference on Behavioral Health Work Force Competencies. Administration and Policy in Mental Health. 2005;32(5–6):651–663. doi:10.1007/s10488-005-3267-x.PubMed Hoge MA, Morris JA, Daniels AS, et al. Report of recommendations: the Annapolis Coalition Conference on Behavioral Health Work Force Competencies. Administration and Policy in Mental Health. 2005;32(5–6):651–663. doi:10.​1007/​s10488-005-3267-x.PubMed
Metadata
Title
Top Manager Effects on Buprenorphine Adoption in Outpatient Substance Abuse Treatment Programs
Authors
Peter D. Friedmann, MD, MPH
Lan Jiang, MS
Jeffrey A. Alexander, PhD
Publication date
01-07-2010
Publisher
Springer US
Published in
The Journal of Behavioral Health Services & Research / Issue 3/2010
Print ISSN: 1094-3412
Electronic ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-009-9169-z

Other articles of this Issue 3/2010

The Journal of Behavioral Health Services & Research 3/2010 Go to the issue