Perceptions of Medications for Addiction Treatment: Views of Affected Family Members

Background/Purpose: Medications for Addiction Treatment (MAT) are highly effective in reducing opioid use and increasing retention in treatment (Connery, 2015). Unfortunately, negative attitudes and misunderstandings about addiction medications are prevalent, contributing to low MAT access and utilization (Volkow et al., 2014). Negative attitudes also contribute to poor outcomes when MAT is utilized (Lee et al., 2015). This qualitative study explored perceptions of medications for treating opioid misuse among adults with a close loved one who misused opioids.

Methods: Semi-structured qualitative interviews (N=35; mean length = 47 minutes; sd=16minutes) were conducted with a purposefully selected sample of adults with a close family member who misused opioids. Participants had children (37.1%), parents (31.4%), siblings (31.4%), or a spouse (2.9%) who misused opioids, and 37.1% had lost their loved one due to substance misuse. The majority of participants were women (68.6%), and they ranged in age from 20 to 74 (mean = 46; sd = 19.5). Most participants self-identified as White (74.3%), and smaller proportions identified as Black/African American (8.5%) and other races/ethnicities (e.g., Native American, Middle Eastern). Interviews included several questions related to MAT, including general thoughts, whether their family member received/considered MAT, and how more families might be encouraged to consider MAT (for those with positive regard toward MAT only). Interviews were audio-recorded, transcribed verbatim, and entered into Dedoose for analysis. Data were coded independently by team members using a thematic approach (Braun & Clarke, 2012). We then used Erickson’s (1986) framework for analytic induction to examine confirming/disconfirming evidence and develop well-supported themes.

Results: While participants’ perceptions of MAT ranged from positive to negative, only a small number (n=8) expressed completely positive or negative views about MAT. Most participants expressed mixed views of medication treatments. Themes included concerns that MAT was simply substituting one drug for another and that treatment medications could be abused by the family member who misused opioids. Other concerns included the length of time medication treatments are used and medication side effects (e.g., weight gain, mood). While family members could identify benefits to MAT they were hesitant to support its wide-spread use and perceived it as a “last resort” treatment. The perception that using medication treatments prevented rather than facilitated full recovery was widely expressed and participants frequently used stigmatizing language, describing MAT as a “band-aid” and an “easy way out”.

Discussion/Implications: Family support is a robust predictor of improved treatment and recovery outcomes (Cavaiola et al., 2015). Lack of family support for MAT may represent an important treatment barrier. Results suggest that while some adults whose family members misuse opioids consider MAT an effective treatment, others have misunderstandings and concerns about medication treatments. Findings highlight how interventions to reduce stigma among family members may be important for increasing MAT utilization and suggest specific areas where education may be needed. Education about the biological mechanisms through which medication treatments work and evidence for the effectiveness of medications may help to increase family members’ support for MAT as a viable intervention for their loved one who misuses opioids.