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Substance Abuse Treatment, Prevention, and Policy
Published in: Substance Abuse Treatment, Prevention, and Policy 1/2015

Open Access 01-12-2015 | Research

Views about responsibility for alcohol addiction and negative evaluations of naltrexone

Authors: Rebecca A Johnson, Jonathan M Lukens, Jonathan W Kole, Dominic A Sisti

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2015

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Abstract

Background

Moral philosophers have debated the extent to which persons are individually responsible for the onset of and recovery from addiction. Empirical investigators have begun to explore counselors’ attitudes on these questions. Meanwhile, a separate literature has investigated counselors’ negative attitudes towards naltrexone, an important element of medication-assisted treatment for alcohol addiction. The present study bridges the literature on counselor views about responsibility for addiction with the literature on attitudes towards naltrexone. It investigates the extent to which a counselor’s views of individual responsibility for alcohol addiction are related to that counselor’s views of naltrexone.

Methods

Using a vignette-based survey of 117 addiction treatment professionals, the study analyzes the relationship between an addiction counselor’s views about individual responsibility for alcohol addiction and using naltrexone to treat it.

Results

We find a significant difference in counselors who assign greater responsibility to a person for the onset of alcohol addiction. They agreed more strongly with several objections to naltrexone, including worries about compliance, naltrexone’s side effects outweighing its benefits, naltrexone treating symptoms but not underlying causes, and the idea that medication may undermine a person’s motivation to recover. Combined views of greater responsibility for addiction’s onset and recovery also significantly predicted stronger agreement with objections.

Conclusions

We conclude that there is a strong relationship between a counselor assigning higher individual responsibility for addiction and holding more negative views about naltrexone. The study also sheds light on one reason why the model of addiction as a brain disease has had limited impact on clinical practice.
Literature
1.
2.
Kloss JD, Lisman SA. Clinician attributions and disease model perspectives of mentally ill, chemically addicted patients: A preliminary investigation. Subst Use Misuse. 2003;38(14):2097–107.CrossRefPubMed
3.
Palm J. The nature of and responsibility for alcohol and drug problems: Views among treatment staff. Addiction Res Theory. 2004;12(5):413–31.CrossRef
4.
Steenbergh TA, Runyan JD, Daugherty DA, Winger JG. Neuroscience exposure and perceptions of client responsibility among addictions counselors. J Subst Abuse Treat. 2012;42(4):421–8.CrossRefPubMed
5.
Russell C, Davies JB, Hunter SC. Predictors of addiction treatment providers’ beliefs in the disease and choice models of addiction. J Subst Abuse Treat. 2011;40(2):150–64.CrossRefPubMed
6.
7.
Maisel NC, Blodgett JC, Wilbourne PL, Humphreys K, Finney JW. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: When are these medications most helpful? Addiction. 2013;108(2):275–93.CrossRefPubMedCentralPubMed
8.
Rösner S, Hackl-Herrwerth A, Leucht S, Vecchi S, Srisurapanont M, Soyka M. Opioid antagonists for alcohol dependence. Cochrane Database of Systematic Rev (Online). 2010;12, CD001867.
9.
10.
Ducharme LJ, Knudsen HK, Roman PM. Trends in the adoption of medications for alcohol dependence. J Clin Psychopharmacol. 2006;26 Suppl 1:13–9.CrossRef
11.
Harris KM, DeVries A, Dimidjian K. Datapoints: Trends in naltrexone use among members of a large private health plan. Psychiatr Serv. 2004;55(3):221.CrossRefPubMed
12.
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.CrossRefPubMed
13.
Thomas CP, Wallack SS, Lee S, McCarty D, Swift R. Research to practice: Adoption of naltrexone in alcoholism treatment. J Subst Abuse Treat. 2003;24(1):1–11.CrossRefPubMed
14.
Forman RF, Bovasso G, Woody G. Staff beliefs about addiction treatment. J Subst Abuse Treat. 2001;21(1):1–9.CrossRefPubMed
15.
Horgan CM, Reif S, Hodgkin D, Garnick DW, Merrick EL. Availability of addiction medications in private health plans. J Subst Abuse Treat. 2008;34(2):147–56.CrossRefPubMedCentralPubMed
16.
McLellan AT, Carise D, Kleber HD. Can the national addiction treatment infrastructure support the public’s demand for quality care? J Subst Abuse Treat. 2003;25(2):112–17.CrossRef
17.
McGovern MP, Fox TS, Xie H, Drake RE. A survey of clinical practices and readiness to adopt evidence-based practices: Dissemination research in an addiction treatment system. J Subst Abuse Treat. 2004;26(4):305–12.CrossRefPubMed
18.
Mulvey KP, Hubbard S, Hayashi S. A national study of the substance abuse treatment workforce. J Subst Abuse Treat. 2003;24(1):51–7.CrossRefPubMed
19.
O’Brien CP. A range of research-based pharmacotherapies for addiction. Science. 1997;278(5335):66–70.CrossRefPubMed
20.
Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60.CrossRefPubMed
21.
Anton RF, Swift RM. Current pharmacotherapies of alcoholism: a U.S. perspective. Am J Addict. 2003;12:s53–68.CrossRefPubMed
22.
23.
Mark TL, Kranzler HR, Song X. Understanding US addiction physicians’ low rate of naltrexone prescription. Drug Alcohol Depend. 2003;71(3):219–28.CrossRefPubMed
24.
Mark TL, Kranzler HR, Poole VH, Hagen CA, Crosse S. Barriers to the use of medications to treat alcoholism. Am J Addictions. 2003;12(4):281–94.CrossRef
25.
26.
27.
28.
29.
Center for Behavioral Health Statistics and Quality. The N-SSATS Report: Acceptance of Private Health Insurance in Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2011.
30.
Rieckmann T, Kovas AE, Rutkowski BA. Adoption of medications in substance abuse treatment: Priorities and strategies of single state authorities. J Psychoactive Drugs. 2010;42 Suppl 6:227–38.CrossRef
31.
Wood E, Samet JH, Volkow ND. Physician education in addiction medicine. JAMA. 2013;310(16):1673–4.CrossRefPubMed
32.
Hammer R, Dingel M, Ostergren J, Partridge B, McCormick J, Koenig BA. Addiction: Current Criticism of the Brain Disease Paradigm. AJOB Neurosci. 2013;4(3):27–32.CrossRefPubMedCentralPubMed
33.
Bell S, Carter A, Mathews R, Gartner C, Lucke J, Hall W. Views of addiction neuroscientists and clinicians on the clinical impact of a ‘brain disease model of addiction. Neuroethics. 2014;7(1):19–27.CrossRef
34.
Whetstone S, Gowan T. Diagnosing the criminal addict: biochemistry in the service of the state. In: McGann PJ, Hutson DJ, editors. Sociology of Diagnosis (Advances in Medical Sociology, Volume 12). Bingley, UK: Emerald Group Publishing Limited; 2011. p. 309–30.
35.
Abraham AJ, Rieckmann T, McNulty T, Kovas AE, Roman PM. Counselor attitudes toward the use of Naltrexone in substance abuse treatment: A multi-level modeling approach. Addict Behav. 2011;36(6):576–83.CrossRefPubMedCentralPubMed
Metadata
Title
Views about responsibility for alcohol addiction and negative evaluations of naltrexone
Authors
Rebecca A Johnson
Jonathan M Lukens
Jonathan W Kole
Dominic A Sisti
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2015
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/s13011-015-0004-7

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