Perceived need and availability of psychosocial interventions across buprenorphine prescriber specialties

Publication date: Available online 16 January 2019

Source: Addictive Behaviors

Author(s): Lewei (Allison) Lin, Michelle R. Lofwall, Sharon L. Walsh, Hannah K. Knudsen

Abstract

Introduction

Psychosocial interventions are often recommended as part of buprenorphine treatment for patients with opioid use disorder, but little is known about prescriber perspectives of their use and how this varies across buprenorphine prescriber specialties.

Methods

A large US sample of physicians actively prescribing buprenorphine (N = 1174) was surveyed from July 2014 to January 2017. Analyses examined prescriber characteristics and their perceptions and use of psychosocial interventions across three groups of physicians: primary care providers (PCPs), addiction physicians/psychiatrists, and other physicians.

Results

Across all prescribers, 93.3% (n = 1061) report most patients would benefit from formal counseling during buprenorphine treatment while only 36.4% (n = 414) believe there are adequate numbers of counselors in their community. Among addiction physicians/psychiatrists, 75.9% (n = 416) report their treatment setting has the resources to provide psychiatric services to patients with complex psychiatric problems compared to 29.1% (n = 130) of PCPs and 29.6% (n = 39, p < .001) of other physicians. Addiction physicians/psychiatrists report a higher proportion of patients received counseling from clinicians in their practice while PCPs report a higher percentage of patients received counseling from external providers.

Conclusions

The majority of prescribers believe patients receiving buprenorphine would benefit from psychosocial interventions and there is variation in how these services are delivered. However, many prescribers, especially those without addiction or psychiatry backgrounds, report their settings do not have adequate psychosocial treatment resources for patients with complex psychosocial needs. Future work developing novel models of psychosocial interventions may be helpful to support prescribers to effectively treat complex patients with opioid use disorders.

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