Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care

Tofighi, Babak; Williams, Arthur Robin; Chemi, Chemi; Suhail-Sindhu, Selena; Dickson, Vicky; Lee, Joshua D.

doi:10.1080/10826084.2019.1653324

Cited by 43 publications

(29 citation statements)

References 28 publications

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“…5,8,9 Although stabilisation on MOUD is ideal, access to long-term care can be problematic, patients are often not interested in MOUD, and many treatment centres do not accept, or have the capabilities to prescribe, MOUD. [10][11][12][13] In these situations, the treatment of opioid withdrawal can itself serve as an end in terms of a pharmacotherapeutic intervention. In this Therapeutics paper, we will assess the current state of treatment for opioid withdrawal, examine innovations and new approaches, and discuss how future research could best be directed towards managing opioid withdrawal, firstly in the context of opioid dose reduction and discontinuation in patients with CNCP and subsequently in the context of MOUD initiation and stabilisation.…”

Section: Emil Kraepelin Morphinism (1899)mentioning

confidence: 99%

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New directions in the treatment of opioid withdrawal

2020

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The treatment of opioid withdrawal is an important area of clinical concern when treating patients with chronic, non-cancer pain, patients with active opioid use disorder, and patients receiving medication for opioid use disorder. Current standards of care for medically supervised withdrawal include treatment with μ-opioid receptor agonists, (eg, methadone), partial agonists (eg, buprenorphine), and α2-adrenergic receptor agonists (eg, clonidine and lofexidine). Newer agents likewise exploit these pharmacological mechanisms, including tramadol (μ-opioid receptor agonism) and tizanidine (α2 agonism). Areas for future research include managing withdrawal in the context of stabilising patients with opioid use disorder to extended-release naltrexone, transitioning patients with opioid use disorder from methadone to buprenorphine, and tapering opioids in patients with chronic, non-cancer pain.

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Section: Emil Kraepelin Morphinism (1899)mentioning

confidence: 99%

“…Defining the optimal strategy to manage opioid withdrawal in patients who refuse medications for opioid use disorder or in situations in which medication is not available [10][11][12][13] • Tramadol is an ideal medication given its low potency and relatively low abuse potential 38…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

New directions in the treatment of opioid withdrawal

2020

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“…Because New York State Medicaid, the largest payor in our OTP system, reimburses with every dosing visit, increasing take-home medication doses can result in a decrease in revenue. Though OTP daily attendance has benefits for patients who require a structured setting, increasing required OTP attendance can interrupt daily routines and serve as a barrier to treatment engagement ( Tofighi et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Reimagining patient-centered care in opioid treatment programs: Lessons from the Bronx during COVID-19

Joseph

Torres-Lockhart

Stein

et al. 2021

Journal of Substance Abuse Treatment

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“…While CJS populations with OUD are typically receptive to initiating SLB treatment during incarceration, [ 9 ] post-release treatment continuation remains challenging, with relatively high drop-out rates immediately post-release compared to new voluntary treatment episodes in community treatment [ 10 , 11 ]. After release, patients often lack stable housing and employment, are re-exposed to drug-using networks, and commonly do not access community treatment resources due to lack of information, high costs, inactive Medicaid, and long wait times [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions and experiences toward extended-release buprenorphine among persons leaving jail with opioid use disorders before and during COVID-19: an in-depth qualitative study

Cheng

Badolato

Segoshi

et al. 2022

Addict Sci Clin Pract

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Background Extended-release buprenorphine (XRB) offers a novel approach to sustained monthly treatment for people who use opioids in criminal justice settings (CJS). This study explores the experiences of adults receiving XRB as a jail-to-community treatment. Methods and findings In-depth qualitative interviews were conducted among adult participants with opioid use disorder (OUD; n = 16) who were recently released from NYC jails and maintained on XRB after switching from daily sublingual buprenorphine (SLB). Interviews elaborated on the acceptability and barriers and facilitators of XRB treatment pre- and post-release. Interviews were audio recorded, transcribed, and analyzed for content related to factors influencing XRB treatment uptake and community reentry. Important themes were grouped into systems, medication, and patient-level factors. Key systems-level factors influencing initiation of XRB in jail included an alternative to perceived stigmatization and privacy concerns associated with daily in-jail SLB administration and less concerns with buprenorphine diversion. In-jail peer networks positively influenced participant adoption of XRB. XRB satisfaction was attributed to reduced in-jail clinic and medication administration visits, perceived efficacy and blockade effects upon the use of heroin/fentanyl following release, and averting the risk of criminal activities to fund opioid use. Barriers to retention included post-injection withdrawal symptoms and cravings attributed to perceived suboptimal medication dosing, injection site pain, and lack of in-jail provider information about the medication. Conclusion Participants were generally favorable to XRB initiation in jail and retention post-release. Further studies are needed to address factors influencing access to XRB in criminal justice settings, including stigma, ensuring patient privacy following initiation on XRB, and patient-, provider-, and correctional staff education pertaining to XRB. Trial Registration ClinicalTrials.gov Identified: NCT03604159.

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Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care

Cited by 43 publications

References 28 publications

New directions in the treatment of opioid withdrawal

New directions in the treatment of opioid withdrawal

Reimagining patient-centered care in opioid treatment programs: Lessons from the Bronx during COVID-19

Perceptions and experiences toward extended-release buprenorphine among persons leaving jail with opioid use disorders before and during COVID-19: an in-depth qualitative study

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