A qualitative study of the adoption of buprenorphine for opioid addiction treatment

Carla A. Green, Dennis McCarty, Jennifer Mertens, Frances L. Lynch, Anadam Hilde, Alison Firemark, Constance M. Weisner, David Pating, Bradley M. Anderson

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Qualified physicians may prescribe buprenorphine to treat opioid dependence, but medication use remains controversial. We examined adoption of buprenorphine in two not-for-profit integrated health plans, over time, completing 101 semi-structured interviews with clinicians and clinician-administrators from primary and specialty care. Transcripts were reviewed, coded, and analyzed. A strong leader championing the new treatment was critical for adoption in both health plans. Once clinicians began using buprenorphine, patients' and other clinicians' experiences affected decisions more than did the champion. With experience, protocols developed to manage unsuccessful patients and changed to support maintenance rather than detoxification. Diffusion outside addiction and mental health settings was nonexistent; primary care clinicians cited scope-of-practice issues and referred patients to specialty care. With greater diffusion came questions about long-term use and safety. Recognizing how implementation processes develop may suggest where, when, and how to best expend resources to increase adoption of such treatments.

Original languageEnglish (US)
Pages (from-to)390-401
Number of pages12
JournalJournal of Substance Abuse Treatment
Volume46
Issue number3
DOIs
StatePublished - Mar 2014

Keywords

  • Buprenorphine
  • Diffusion of technology
  • Implementation research
  • Medication adoption
  • Opioid addiction
  • Qualitative research

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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    Green, C. A., McCarty, D., Mertens, J., Lynch, F. L., Hilde, A., Firemark, A., Weisner, C. M., Pating, D., & Anderson, B. M. (2014). A qualitative study of the adoption of buprenorphine for opioid addiction treatment. Journal of Substance Abuse Treatment, 46(3), 390-401. https://doi.org/10.1016/j.jsat.2013.09.002