Attitudes and knowledge of substance misusers regarding buprenorphine and methadone maintenance therapy

Abstract

Aims: To assess substance users' beliefs and the sources of these beliefs regarding methadone and buprenorphine and to examine how they choose between them. Design: Forty-two opiate-dependent patients seeking treatment chose between open label buprenorphine or methadone maintenance treatment. Prior to treatment patients completed a semi-structured interview or a self-completed questionnaire. Findings: Beliefs were based primarily on their own or other users' experiences. All patients chose their treatment. There was little difference between those choosing MMT and BMT in terms of their beliefs about the drugs, although the BMT group viewed methadone more negatively and buprenorphine more positively than the MMT group. Those choosing MMT appeared to do so on the basis of familiarity whereas those choosing BMT appeared to be attracted by their beliefs that it would block heroin more effectively, reduce craving, give less intoxication and be easier to stop taking. Conclusions: Opiate users rapidly become well informed about a new treatment when it becomes available. They rely more on their own and other users' experience than the information given by agencies. Choices between treatments are based more on individual perceived requirements than different beliefs

Outcomes from the International Survey Informing Greater Insights in Opioid Dependence Treatment (INSIGHT) project

“…It is encouraging that patients are involved with making choices about their treatment but concerning that many patients are leading treatment choices based on limited knowledge of their treatment options. Knowledge, beliefs, perceptions and attitudes of opioid users towards MAT may influence therapeutic outcomes and treatment retention (Fischer, Chin, Kuo, Kirst, & Vlahov, 2002;Kayman, Goldstein, Deren, & Rosenblum, 2006;Madden, Lea, Bath, & Winstock, 2008;Pinto, Rumball, & Holland, 2008) and so it is important that patients are given accurate information from credible sources about all treatment options available to them. Ultimately, HCPs and well-informed patients should make decisions about the treatment together with the goal of finding the best solution for each individual.…”

Patients' knowledge about treatment for opiate dependence

“…8 A growing body of evidence now suggests that variables such as the knowledge, beliefs, perceptions and attitudes of opioid users towards opioid pharmacotherapy may influence therapeutic outcomes and early treatment drop out. [9][10][11][12][13] A recent Australian study of opioid users' knowledge and attitudes about opioid treatment identified significant gaps in knowledge about many aspects of treatment including medication, treatment benefits, risks and perceived side-effects. 14 These data corroborated previous findings that revealed opioid users' dissatisfaction with the information provided by their doctors regarding medications' pharmacological properties and treatment options.…”

Interest in Extended Release Naltrexone among Opioid Users

“…This would not only increase the validity of data, but could also serve the purpose of giving information to opioid users who may have avoided the current treatment While there is often limited continuity between attitude and behaviour [24] , there is reason to believe that continuity could be higher in the present scenario as user interest in XR-NTX is specific and behaviour-oriented. In addition, user preference among opioid users is known to be highly relevant to treatment choice and adherence [6] . The extent to which reported interest in XR-NTX predicts actual induction and adherence to clinical treatment with XR-NTX merits further investigation.…”

“…Opioid users are known to have strong opinions about the type of treatment they receive [6][7][8][9] , and this is likely to influence their treatmentseeking behaviour and adherence, as well as propensity to adhere to advice from caretakers.…”