Attending a Biopsychosocially Focused Buprenorphine Training Improves Clinician Attitudes.

Holly Ann Russell,Brian Smith,Elizabeth Loomis,Mechelle Sanders

doi:10.3389/fpsyt.2021.639826

Abstract

Objective: Substance use disorders remain highly stigmatized. Access to medications for opioid use disorder is poor. There are many barriers to expanding access including stigma and lack of medical education about substance use disorders. We enriched the existing, federally required, training for clinicians to prescribe buprenorphine with a biopsychosocial focus in order to decrease stigma and expand access to medications for opioid use disorder.Methods: We trained a family medicine team to deliver an enriched version of the existing buprenorphine waiver curriculum. The waiver training was integrated into the curriculum for all University of Rochester physician and nurse practitioner family medicine residents and also offered to University of Rochester residents and faculty in other disciplines and regionally. We used the Brief Substance Abuse Attitudes Survey to collect baseline and post-training data.Outcomes: 140 training participants completed attitude surveys. The overall attitude score increased significantly from pre to post-training. Additionally, significant changes were observed in non-moralism from pre-training (M = 20.07) to post-training (M = 20.98, p < 0.001); treatment optimism from pre-training (M = 21.56) to post-training (M = 22.33, p < 0.001); and treatment interventions from pre-training (M = 31.03) to post-training (M = 32.10, p < 0.001).Conclusion: Increasing medical education around Opioid Use Disorder using a Family Medicine trained team with a biopsychosocial focus can improve provider attitudes around substance use disorders. Enriching training with cases may improve treatment optimism and may help overcome the documented barriers to prescribing medications for opioid use disorder and increase access for patients to lifesaving treatments.

Highlights

Substance use disorders (SUDs) are among the most stigmatized conditions in the US and around the world [1]
Stigma against people with opioid use disorder (OUD) and other SUDs affect the frequency with which people are offered effective treatment as well as how often they are willing to engage in care [2]
Our faculty worked with experts in the field to become certified to deliver nationally recognized trainings on all forms of OUD treatment through the American Society of Addiction Medicine (ASAM) and the American Academy of Addiction Psychiatry (AAAP)

Summary

Introduction

Substance use disorders (SUDs) are among the most stigmatized conditions in the US and around the world [1]. Stigma against people with opioid use disorder (OUD) and other SUDs affect the frequency with which people are offered effective treatment as well as how often they are willing to engage in care [2]. Clinicians explicitly acknowledge treatment pessimism and Buprenorphine Training and Clinician Attitudes negative stereotypes about patients with OUDs as a barrier to offering care [3, 4]. Efforts to increase the understanding of substance use disorders as a chronic disease have highlighted the underlying neurobiological changes and focused on biomedical approaches to treatment. At times this approach may have furthered the stigma surrounding opioid use disorder [6]. We would never describe the use of metformin for diabetes as medication assisted treatment or say medication assisted treatment when advocating for diuretics for blood pressure management

Methods

Results

Conclusion