Stigma Surrounding the Use of Medically Assisted Treatment for Opioid Use Disorder

Witte, Tricia H.; Jaiswal, Jessica; Mumba, Mercy Ngosa; Mugoya, George C. T.

doi:10.1080/10826084.2021.1936051

Cited by 21 publications

(10 citation statements)

References 52 publications

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“…The direct messaging and CMB features of the HOPE app are novel among MAT-specific mHealth apps [ 13 - 15 ] and may be particularly important for fostering rapport and decreasing mistrust. Trusting therapeutic relationships are especially critical for patients who have faced stigma and other barriers to care [ 39 , 40 ]. Prior studies of messaging between patients and providers over apps or patient portals indicates that messaging can serve not only as a vehicle for efficient communication but also as a means of furthering the therapeutic relationship between patient and provider [ 22 - 24 ].…”

Section: Discussionmentioning

confidence: 99%

Communication between patients, peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

Flickinger

Waselewski

Tabackman

et al. 2022

Patient Education and Counseling

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Section: Discussionmentioning

confidence: 99%

Communication between patients, peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

Flickinger

Waselewski

Tabackman

et al. 2022

Patient Education and Counseling

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“…Individuals in recovery from OUD who use MAR experience two sites where the stigma complex affects self-concept and recovery decisions: one based on their condition (OUD), and another based on their treatment intervention (MAR) (Hewell, Vasquez, and Rivkin 2017;Madden 2019;Witte et al 2021). Regardless of the specific medication, the use of a substance to stay in recovery and avoid feeling sick contradicts the prevailing sentiment that "true recovery" requires abstinence from all substances and in so doing, it triggers stigmatizing responses (R. E. Stewart et al 2021).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Provider-based stigma is "prejudice and discrimination voiced or exercised, consciously or unconsciously by occupational groups designated to help stigmatized groups" (Pescosolido and Martin 2015). Physicians, addiction counselors, and service providers stigmatize MAR (Hewell et al 2017;van Boekol et al 2013;Luoma et al 2007;Witte et al 2021). In SUD treatment systems, stigma may be rooted in firsthand experiences with drug use/recovery (R. E. Stewart et al 2021), burnout from caring for a high caseload of patients, and emotional exhaustion associated with caring for patients with dual diagnoses (Scott et al 2021;Van Boekol et al 2013).…”

Section: Literature Reviewmentioning

confidence: 99%

Medication Assisted Recovery: A Social Ecological Approach to Understanding How Stigma Shapes Effective Use

Fry

Shircliff

Benham

et al. 2023

Journal of Applied Social Science

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Stigma is a well-documented barrier to effective individual and community response to mental illness and, in recent years, is a recognized impediment to prevention and treatment of substance use disorders (SUDs). This study uses focus group data to explore stigmatizing views of medication assisted recovery (MAR) among those in recovery and the people, organizations, and communities that surround them, with attention to implications for long-term recovery. Across groups, we find consistent themes that MAR simply trades one drug for another, MAR should be used only as a stepping-stone to full abstinence, and that long-term use of MAR indicates ineffectiveness or treatment failure. Data suggest the prevalence of these perceptions leads those in recovery and providers to see MAR as a last resort treatment, encourages individuals to discontinue MAR before they are ready, and as result increases risk of relapse and overdose.

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“…5 Despite great efforts made to mitigate the opioid overdose crisis, barriers preventing treatment still exist for patients with OUD including lack of healthcare access in rural areas, buprenorphine and methadone prescribing regulations, and stigma from the community. [6][7][8] While methadone can only be dispensed at an opioid treatment program (OTP), buprenorphine is prescribed by a licensed physician through an office-based opioid treatment (OBOT) program for patients to take outside of an OTP setting. 9 Access to medications for OUD (MOUD) remains challenging, especially in rural areas.…”

Section: Introductionmentioning

confidence: 99%

Pharmacist‐delivered comprehensive medication management in a substance use disorder clinic, an 18‐month descriptive study

Tran

Hager

2023

J Am Coll Clin Pharm

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Introduction Pharmacists have expanded their roles within interprofessional teams in substance use disorder (SUD) care, but data characterizing pharmacist‐delivered comprehensive medication management (CMM) in outpatient SUD treatment are limited. Objectives The purpose of this study was to characterize the patient population, and medication therapy problems (MTPs), and describe considerations for CMM development and implementation in an outpatient SUD treatment setting. Methods An observational, prospective, descriptive study was conducted in an outpatient SUD center. A clinical pharmacist provided CMM services to referred clients and documented data elements after each visit. The pharmacist comprehensively assessed clients' complete regimens to optimize medication use through collaboration with the clients and other healthcare providers. A post‐CMM electronic survey was sent to the clients' care teams to assess their attitudes and collect feedback regarding the collaboration process. Descriptive statistics were employed to describe the population, CMM services, MTPs, and survey responses. Results From April 1, 2021, to September 30, 2022, a total of 187 CMM encounters were delivered to a total of 112 clients with SUD. Nearly all patients (99%) had opioid use disorder as their primary diagnosis and the vast majority (95%) were receiving methadone treatment. Clients’ mean age was 39‐years‐old with an average of eight medications and six medical conditions. Of 201 MTPs identified, 54 MTPs (27%) were marked as “resolved” at follow‐up visits. The most commonly identified MTP category was the need for additional drug therapy (31%). The care team survey showed 100% agreed or strongly agreed that the CMM consult was helpful to the clients and the care team members. Conclusion Pharmacist‐delivered CMM in a SUD treatment setting was feasible and well perceived by care team members as helpful to bridge existing gaps in access to biomedical care, medication optimization, and medication use care coordination.

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Stigma Surrounding the Use of Medically Assisted Treatment for Opioid Use Disorder

Cited by 21 publications

References 52 publications

Communication between patients, peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

Communication between patients, peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

Medication Assisted Recovery: A Social Ecological Approach to Understanding How Stigma Shapes Effective Use

Pharmacist‐delivered comprehensive medication management in a substance use disorder clinic, an 18‐month descriptive study

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