Methadone, buprenorphine and preferences for opioid agonist treatment: A qualitative analysis

Bobbi Jo H Yarborough, Scott P. Stumbo, Dennis McCarty, Jennifer Mertens, Constance Weisner, Carla A. Green

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Patients and clinicians have begun to recognize the advantages and disadvantages of buprenorphine relative to methadone, but factors that influence choices between these two medications remain unclear. For example, we know little about how patients' preferences and previous experiences influence treatment decisions. Understanding these issues may enhance treatment engagement and retention. Methods: Adults with opioid dependence (n = 283) were recruited from two integrated health systems to participate in interviews focused on prior experiences with treatment for opioid dependence, knowledge of medication options, preferences for treatment, and experiences with treatment for chronic pain in the context of problems with opioids. Interviews were audio-recorded, transcribed verbatim, and coded using Atlas.ti. Results: Our analysis revealed seven areas of consideration for opioid agonist treatment decision-making: (1) awareness of treatment options; (2) expectations and goals for duration of treatment and abstinence; (3) prior experience with buprenorphine or methadone; (4) need for accountability and structured support; (5) preference to avoid methadone clinics or associated stigma; (6) fear of continued addiction and perceived difficulty of withdrawal; and (7) pain control. Conclusion: The availability of medication options increases the need for clear communication between clinicians and patients, for additional patient education about these medications, and for collaboration and patient influence over choices in treatment decision-making. Our results suggest that access to both methadone and buprenorphine will increase treatment options and patient choice and may enhance treatment adherence and outcomes.

Original languageEnglish (US)
Pages (from-to)112-118
Number of pages7
JournalDrug and Alcohol Dependence
Volume160
DOIs
StatePublished - Mar 1 2016

Fingerprint

Buprenorphine
Methadone
Opioid Analgesics
Decision making
Therapeutics
Education
Health
Availability
Decision Making
Interviews
Communication
Patient Preference
Atlases
Social Responsibility
Patient Education
Chronic Pain
Fear
Pain

Keywords

  • Buprenorphine
  • Methadone
  • Opioid addiction
  • Qualitative research

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Toxicology
  • Pharmacology
  • Pharmacology (medical)

Cite this

Methadone, buprenorphine and preferences for opioid agonist treatment : A qualitative analysis. / Yarborough, Bobbi Jo H; Stumbo, Scott P.; McCarty, Dennis; Mertens, Jennifer; Weisner, Constance; Green, Carla A.

In: Drug and Alcohol Dependence, Vol. 160, 01.03.2016, p. 112-118.

Research output: Contribution to journalArticle

Yarborough, Bobbi Jo H ; Stumbo, Scott P. ; McCarty, Dennis ; Mertens, Jennifer ; Weisner, Constance ; Green, Carla A. / Methadone, buprenorphine and preferences for opioid agonist treatment : A qualitative analysis. In: Drug and Alcohol Dependence. 2016 ; Vol. 160. pp. 112-118.
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