康复社区中心参与者对阿片类药物使用障碍药物治疗的态度。
Attitudes toward opioid use disorder pharmacotherapy among recovery community center attendees.
机构信息
Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, United States of America.
Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, United States of America.
出版信息
J Subst Abuse Treat. 2021 Dec;131:108464. doi: 10.1016/j.jsat.2021.108464. Epub 2021 May 8.
BACKGROUND
Despite their proven efficacy, medications for opioid use disorder (MOUD) are underutilized. Negative beliefs and attitudes toward MOUD are quite common, yet rapidly expanding recovery community centers (RCCs) may offer a promising venue for fostering MOUD support as they operate under the maxim, "many pathways [to recovery], all should be celebrated" and are utilized mainly by those with opioid use disorder. The current study provides a first look at MOUD attitudes and their correlates in RCC attendees.
METHODS
The study conducted a cross-sectional survey (N = 320) of recovering adults attending 31 RCCs across New England, assessing demographic, treatment, and recovery-relevant factors, as well attitudes (positive vs. negative) toward the use of agonist and antagonist MOUD. The study used frequencies and confidence intervals to obtain prevalence estimates for positive and negative attitudes toward agonist and antagonist MOUD, and to examine differences between them. Spearman correlations identified correlates of MOUD attitudes (at p < 0.10), and significant correlates were assessed for unique contributions via multivariable logistic regression.
RESULTS
Positive attitudes were common and more prevalent than negative attitudes for both agonist (positive: 71.4 [66.1, 76.3]%; negative: 28.6 [23.7, 33.9]%) and antagonist (positive: 76.5 [71.4, 81.1]%; negative: 23.5 [18.9, 28.6]%) MOUD, which did not differ. The study identified several correlates of MOUD attitudes at the p < 0.10 level, but only four variables emerged as unique predictors controlling for other correlates. Lifetime history of agonist MOUD treatment was uniquely associated with positive agonist attitudes (p = 0.008), whereas greater social support for recovery was associated with positive antagonist attitudes (p = 0.007). Lower educational attainment was uniquely associated with negative antagonist attitudes (p = 0.005), and a greater degree of spirituality was related to negative attitudes toward both agonists (p = 0.005) and antagonists (p = 0.01).
CONCLUSIONS
Findings reveal very high rates of positive MOUD attitudes among RCC participants, highlighting the potential for this growing tier of recovery support to foster acceptance and peer support for medication-facilitated recovery pathways. Correlates of attitudes further reveal opportunities for facilitating MOUD acceptance within and beyond the RCC network.
背景
尽管阿片类药物使用障碍（MOUD）药物已被证实有效，但它们的使用仍不充分。人们对 MOUD 的负面观念和态度很常见，但快速发展的康复社区中心（RCC）可能提供了一个有前途的场所，可以促进 MOUD 的支持，因为它们的宗旨是“[康复的]多种途径，都应受到庆祝”，并且主要由阿片类药物使用者使用。目前的研究首次探讨了 RCC 参与者对 MOUD 的态度及其相关因素。
方法
该研究对新英格兰地区 31 个 RCC 中康复的成年人进行了横断面调查（N=320），评估了人口统计学、治疗和康复相关因素，以及对使用激动剂和拮抗剂 MOUD 的态度（积极与消极）。该研究使用频率和置信区间来获得对激动剂和拮抗剂 MOUD 的积极和消极态度的流行率估计，并检查它们之间的差异。Spearman 相关性确定了 MOUD 态度的相关因素（p<0.10），并通过多变量逻辑回归评估了显著相关因素的独特贡献。
结果
积极的态度很常见，并且比消极的态度更为普遍，无论是激动剂（积极：71.4%[66.1%，76.3%]；消极：28.6%[23.7%，33.9%]）还是拮抗剂（积极：76.5%[71.4%，81.1%]；消极：23.5%[18.9%，28.6%]）MOUD 都没有差异。该研究在 p<0.10 水平上确定了几个与 MOUD 态度相关的因素，但只有四个变量在控制其他因素后成为了独特的预测因素。终生接受激动剂 MOUD 治疗的历史与积极的激动剂态度具有独特的相关性（p=0.008），而更多的康复社会支持与积极的拮抗剂态度相关（p=0.007）。较低的教育程度与消极的拮抗剂态度具有独特的相关性（p=0.005），而更大的精神信仰与对激动剂（p=0.005）和拮抗剂（p=0.01）的消极态度相关。
结论
研究结果表明，RCC 参与者对 MOUD 的积极态度率非常高，这突显了这一日益壮大的康复支持网络在促进对药物辅助康复途径的接受和同伴支持方面的潜力。态度的相关性进一步揭示了在 RCC 网络内外促进 MOUD 接受的机会。
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