Public Perception of the Efficacy of Medications for Opioid Addiction Treatment

Introduction/Background: Medications for Addiction Treatment (MAT) have been shown to be highly efficacious in reducing opioid use, and increasing retention in treatment and prosocial behaviors (Volkow et al., 2014; Connery, 2015). Additionally, increasing availability of MAT has been associated with fewer fatal overdose deaths and lower rates of disease transmission (Volkow et al., 2015). Unfortunately, negative attitudes and misunderstandings about addiction medications held by the public, providers, and patients are barriers that contribute to low access to and utilization of MAT (Volkow et al., 2014). The goal of the current study was to examine public views on the efficacy of medications for treating opioid misuse. Identifying individuals who are less supportive of MAT could help guide targeted psychoeducation efforts to correct common misconceptions, decrease stigma associated with MAT, and increase engagement in evidence-based practices.

Methods: Adults 18 and older (N=721) were recruited through paid Facebook advertising to complete an online health survey. Participants were asked whether they considered medication treatments (e.g. methadone) to be effective for treating opioid misuse. Other questions assessed perceptions and knowledge related to opioids (e.g. the extent to which they believe that prescription medication and heroin problems can improve with treatment, and knowledge of opioid overdose and prevention). Participants also reported demographic characteristics (e.g., age, gender, zip code, race/ethnicity). Logistic regression was used to examine whether these factors were associated with the view that MAT is an effective treatment for opioid use disorders. In order to and identify more accurate parameter estimates and utilize the full sample, including those respondents who had at least one missing value (27.7% of the sample), multiple imputation was used to handle missing data (Enders, 2013).

Results: 41% of respondents considered MAT an effective treatment for opioid use disorders. Results of the logistic regression indicate that rural residents had lower odds of considering MAT to be an effective treatment for treating opioid misuse (OR=0.599, p=.045). Individuals who believed prescription medication misuse can improve with treatment had greater odds of considering MAT to be effective (OR=2.32, p<.001). Individuals with more knowledge of opioids (e.g. overdoses can be reversed) (OR=1.27; p=.027, had greater odds of considering MAT effective.

Conclusions/Implications: There are already numerous barriers to MAT in rural areas (e.g., lack of providers, long travel times); attitudes towards MAT may represent an additional barrier. Education about MAT in rural areas may be particularly beneficial in increasing engagement in MAT. Those who believed that prescription medication misuse can improve with treatment and those with more knowledge of opioids were more likely to believe that MAT is efficacious. Thus, individuals with less stigmaizing beliefs about opioid use generally may be more open to MAT, and interventions to reduce stigma may be important for increasing MAT utilization.

Connery, H. S. (2015). Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harvard review of psychiatry, 23(2), 63-75.

Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies—tackling the opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.