TY - JOUR
T1 - Research to practice
T2 - Adoption of naltrexone in alcoholism treatment
AU - Thomas, Cindy Parks
AU - Wallack, Stanley S.
AU - Lee, Sue
AU - McCarty, Dennis
AU - Swift, Robert
N1 - Funding Information:
Funding for this study was provided by the National Institute on Alcohol Abuse and Alcoholism Grant No. AA11740. The authors would like to thank Michael Hilton, Ph.D., for guidance as we conducted this project, and Linda Simoni-Wastila, Ph.D., Connie Horgan, Ph.D., and Christine E. Bishop, Ph.D., for collaboration and insights. We would also like to acknowledge the following individuals for their assistance in conducting this research: Grant Ritter, Ph.D., for statistical assistance; Clare O'Connor, Namrata Nandakumar, and Natasha Williams for help in data collection and analysis; and the many alcoholism treatment providers who provided feedback in survey development.
PY - 2003/1
Y1 - 2003/1
N2 - Naltrexone, a prescription medication, was approved in December 1994 as an adjunct to counseling in treatment of alcoholism and alcohol abuse, representing the first new medication for alcoholism in several decades. Initial controlled trials indicated that it is effective in preventing relapse, while later trials show mixed results. Although many physicians and others treating alcoholism have found naltrexone to be very helpful in treatment, it is still a technology that has not been used widely. In this study, we examine which clinicians have adopted naltrexone into practice for what reasons, and what clinical and nonclinical factors acted as barriers to its use. In our mail survey of alcoholism treatment clinicians, 80% of physicians and 45% of nonphysicians report prescribing or recommending naltrexone at least rarely, but only 15% of physicians, even among addiction specialists, prescribe naltrexone often. The strongest barriers to adoption of naltrexone were financing and inadequate knowledge about the medication, followed by lack of sufficient evidence regarding effectiveness. Clinicians were most likely to adopt naltrexone if they were affiliated with treatment programs that actively promoted its use. We conclude that in order for a new substance abuse treatment medication to be widely adopted in clinical practice, information about it must be properly directed, clinicians must be convinced of its effectiveness, it must be adequately financed, and the treatment organizations in which clinicians work must promote its use.
AB - Naltrexone, a prescription medication, was approved in December 1994 as an adjunct to counseling in treatment of alcoholism and alcohol abuse, representing the first new medication for alcoholism in several decades. Initial controlled trials indicated that it is effective in preventing relapse, while later trials show mixed results. Although many physicians and others treating alcoholism have found naltrexone to be very helpful in treatment, it is still a technology that has not been used widely. In this study, we examine which clinicians have adopted naltrexone into practice for what reasons, and what clinical and nonclinical factors acted as barriers to its use. In our mail survey of alcoholism treatment clinicians, 80% of physicians and 45% of nonphysicians report prescribing or recommending naltrexone at least rarely, but only 15% of physicians, even among addiction specialists, prescribe naltrexone often. The strongest barriers to adoption of naltrexone were financing and inadequate knowledge about the medication, followed by lack of sufficient evidence regarding effectiveness. Clinicians were most likely to adopt naltrexone if they were affiliated with treatment programs that actively promoted its use. We conclude that in order for a new substance abuse treatment medication to be widely adopted in clinical practice, information about it must be properly directed, clinicians must be convinced of its effectiveness, it must be adequately financed, and the treatment organizations in which clinicians work must promote its use.
KW - Alcoholism treatment
KW - Diffusion
KW - Medication
KW - Naltrexone
KW - Prescribing
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U2 - 10.1016/S0740-5472(02)00319-7
DO - 10.1016/S0740-5472(02)00319-7
M3 - Article
C2 - 12646325
AN - SCOPUS:0037223822
SN - 0740-5472
VL - 24
SP - 1
EP - 11
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
IS - 1
ER -