Experiences with Medications for Addiction Treatment Among Emergency Department Patients with Opioid Use Disorder
Authors
Goldfine, Charlotte EChapman, Brittany P
Taylor, Melissa M
Bradley, Evan S
Carreiro, Stephanie
Rosen, Rochelle K
Babu, Kavita M
Lai, Jeffrey T
UMass Chan Affiliations
Emergency MedicineDocument Type
Journal ArticlePublication Date
2023-02-22
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Introduction: Medications for addiction treatment (MAT) are the evidence-based standard of care for treatment of opioid use disorder (OUD), but stigma continues to surround their use. We conducted an exploratory study to characterize perceptions of different types of MAT among people who use drugs. Methods: We conducted this qualitative study in adults with a history of non-medical opioid use who presented to an emergency department for complications of OUD. A semi-structured interview that explored knowledge, perceptions, and attitudes toward MAT was administered, and applied thematic analysis conducted. Results: We enrolled 20 adults. All participants had prior experience with MAT. Among participants indicating a preferred treatment modality, buprenorphine was the commonly favored agent. Previous experience with prolonged withdrawal symptoms upon MAT discontinuation and the perception of "trading one drug for another" were common reasons for reluctance to engage in agonist or partial-agonist therapy. While some participants preferred treatment with naltrexone, others were unwilling to initiate antagonist therapy due to fear of precipitated withdrawal. Most participants strongly considered the aversive nature of MAT discontinuation as a barrier to initiating treatment. Participants overall viewed MAT positively, but many had strong preferences for a particular agent. Conclusion: The anticipation of withdrawal symptoms during initiation and cessation of treatment affected willingness to engage in a specific therapy. Future educational materials for people who use drugs may focus on comparisons of respective benefits and drawbacks of agonists, partial agonists, and antagonists. Emergency clinicians must be prepared to answer questions about MAT discontinuation to effectively engage patients with OUD.Source
Goldfine CE, Chapman BP, Taylor MM, Bradley ES, Carreiro SP, Rosen RK, Babu KM, Lai JT. Experiences with Medications for Addiction Treatment Among Emergency Department Patients with Opioid Use Disorder. West J Emerg Med. 2023 Feb 22;24(2):236-242. doi: 10.5811/westjem.2022.9.57821. PMID: 36976598; PMCID: PMC10047725.DOI
10.5811/westjem.2022.9.57821Permanent Link to this Item
http://hdl.handle.net/20.500.14038/52031PubMed ID
36976598Rights
Copyright: © 2023 Goldfine et al. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/ licenses/by/4.0/; Attribution 4.0 InternationalDistribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.5811/westjem.2022.9.57821
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