Physician's Attitudes Toward Patients With Opioid Use Disorder and Use of Medications for Opioid Use Disorder Vary by Training.

Bridget C Bailey, Helen Anne Sweeney, Erin L Winstanley, Christopher Lopez, Laura Potts
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Abstract

Objectives: This study compared whether different addiction treatment educational experiences were associated with physicians' attitudes toward patients with opioid use disorder (OUD) and perceived efficacy of medications for opioid use disorder (MOUD).

Methods: Ohio physicians (n = 2757) with and without a waiver to prescribe buprenorphine (Drug Addiction Treatment Act 2000 [DATA 2000] waiver) were surveyed regarding their attitudes toward treating patients with OUD and on the effectiveness of MOUD. We divided physicians into 3 groups: physicians with DATA 2000 waivers, non-waivered physicians with experiential training, and non-waivered physicians without experiential training. We defined experiential training as educational experience directly working with individuals with OUD including those in recovery. Analysis of variance was used to detect statistically significant group differences.

Results: We found significant main effect differences in attitudes toward patients with OUD and perceived efficacy of MOUD between groups (P ≤ .01) for all but one attitude. Post hoc comparisons revealed waivered physicians had the most favorable attitudes. Among physicians without a waiver, those with experiential training had significantly more favorable attitudes toward treating OUD and perceived MOUD to be more effective, including items such as "OUD are treatable illnesses" and "medication assisted treatment is a crucial part of treatment for OUD."

Conclusion: The results suggest that physicians with DATA 2000 waiver and experiential training, as compared to physicians without either a waiver or experiential training in OUD, are associated with less stigmatizing views of treating patients with OUD and prescribing MOUD. While legislation in December 2022 eliminated DATA 2000 waiver training requirement, these findings suggest an ongoing need for training opportunities.

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医生对阿片类药物使用障碍患者的态度和阿片类药物使用障碍药物的使用因培训而异。
目的:本研究比较了不同的成瘾治疗教育经历是否与医生对阿片类药物使用障碍(OUD)患者的态度以及对阿片类药物使用障碍(MOUD)药物疗效的认知有关:本研究比较了不同的成瘾治疗教育经历是否与医生对阿片类药物使用障碍(OUD)患者的态度以及对阿片类药物使用障碍(MOUD)药物疗效的认知有关:我们对俄亥俄州拥有和未拥有丁丙诺啡处方豁免权(《2000 年药物成瘾治疗法案》[DATA 2000] 豁免权)的医生(n = 2757 人)进行了调查,以了解他们对治疗阿片类药物使用障碍患者的态度和 MOUD 的疗效。我们将医生分为三组:拥有《2000 年药物成瘾治疗法》豁免权的医生、接受过经验培训的非豁免医生和未接受过经验培训的非豁免医生。我们将经验培训定义为直接与 OUD 患者(包括康复中的患者)打交道的教育经验。我们采用方差分析来检测具有统计学意义的群体差异:结果:我们发现,除一种态度外,各组对 OUD 患者的态度和对 MOUD 疗效的感知均存在明显的主效应差异(P ≤ .01)。事后比较显示,有弃权声明的医生的态度最为积极。在没有弃权的医生中,接受过经验培训的医生对治疗 OUD 的态度明显更积极,并认为 MOUD 更有效,包括 "OUD 是可以治疗的疾病 "和 "药物辅助治疗是治疗 OUD 的关键部分 "等项目:结果表明,与未获得豁免或未接受过 OUD 经验培训的医生相比,接受过 DATA 2000 豁免和经验培训的医生对治疗 OUD 患者和开具 MOUD 的污名化观点较少。虽然 2022 年 12 月的立法取消了 DATA 2000 豁免培训要求,但这些研究结果表明仍需要培训机会。
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