Skip to main content
Top
Published in: Current Psychiatry Reports 5/2011

01-10-2011

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

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

Published in: Current Psychiatry Reports | Issue 5/2011

Login to get access

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.
Literature
1.
go back to reference 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. 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Knudsen HK, Abraham AJ, Roman PM. Adoption and implementation of medications in addiction treatment programs. J Addict Med. 2011;5(1):21–7.PubMedCrossRef 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.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference • 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 • 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
10.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Boothby LA, Doering PL. Acamprosate for the treatment of alcohol dependence. Clin Ther. 2005;27(6):695–714.PubMedCrossRef Boothby LA, Doering PL. Acamprosate for the treatment of alcohol dependence. Clin Ther. 2005;27(6):695–714.PubMedCrossRef
14.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Garbutt JC. Efficacy and tolerability of naltrexone in the management of alcohol dependence. Curr Pharm Des. 2010;16(19):2091–7.PubMedCrossRef Garbutt JC. Efficacy and tolerability of naltrexone in the management of alcohol dependence. Curr Pharm Des. 2010;16(19):2091–7.PubMedCrossRef
18.
go back to reference Rösner S, Hackl-Herrwerth A, Leucht S, et al. Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev 2010, Issue 12. Art. No.: CD001867. 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Rösner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev 2010, Issue 9. Art. No.: CD004332. Rösner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev 2010, Issue 9. Art. No.: CD004332.
22.
go back to reference 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. 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference Barnett PG. Comparison of costs and utilization among buprenorphine and methadone patients. Addiction. 2009;104(6):982–92.PubMedCrossRef Barnett PG. Comparison of costs and utilization among buprenorphine and methadone patients. Addiction. 2009;104(6):982–92.PubMedCrossRef
26.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference Sullivan LE, Fiellin DA. Narrative review: buprenorphine for opioid-dependent patients in office practice. Ann Intern Med. 2008;148(9):662–70.PubMed Sullivan LE, Fiellin DA. Narrative review: buprenorphine for opioid-dependent patients in office practice. Ann Intern Med. 2008;148(9):662–70.PubMed
30.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference • 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. • 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Abraham AJ, Ducharme LJ, Roman PM. Counselor attitudes toward pharmacotherapies for alcohol dependence. J Stud Alcohol Drugs. 2009;70(4):628–35.PubMed Abraham AJ, Ducharme LJ, Roman PM. Counselor attitudes toward pharmacotherapies for alcohol dependence. J Stud Alcohol Drugs. 2009;70(4):628–35.PubMed
49.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference Drake R, Skinner J, Goldman HH. What explains the diffusion of treatments for mental illness? Am J Psychiatry. 2008;165(11):1385–92.PubMedCrossRef 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.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference Dackis C, O’Brien C. Neurobiology of addiction: treatment and public policy ramifications. Nat Neurosci. 2005;8(11):1431–6.PubMedCrossRef Dackis C, O’Brien C. Neurobiology of addiction: treatment and public policy ramifications. Nat Neurosci. 2005;8(11):1431–6.PubMedCrossRef
57.
go back to reference 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 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.
go back to reference 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. 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.
go back to reference 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. 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.
go back to reference 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 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.
go back to reference Fornili K, Burda C. Buprenorphine prescribing: why physicians aren’t and nurse prescribers can’t. J Addict Nurs. 2009;20(4):218–26.CrossRef 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference Gordon AJ, Liberto J, Granda S, et al. Physician training is never a failure. Am J Addict. 2009;18(4):337–8.CrossRef Gordon AJ, Liberto J, Granda S, et al. Physician training is never a failure. Am J Addict. 2009;18(4):337–8.CrossRef
68.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 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
Metadata
Title
Barriers to Use of Pharmacotherapy for Addiction Disorders and How to Overcome Them
Authors
Elizabeth M. Oliva
Natalya C. Maisel
Adam J. Gordon
Alex H. S. Harris
Publication date
01-10-2011
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 5/2011
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-011-0222-2

Other articles of this Issue 5/2011

Current Psychiatry Reports 5/2011 Go to the issue