Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
Department of Urology, Beaumont Hospital, Royal Oak, MI, USA.
Subst Use Addctn J. 2024 Oct;45(4):706-715. doi: 10.1177/29767342241254591. Epub 2024 Jun 3.
Medications for opioid use disorders (MOUDs) are effective, but most people with opioid use disorder (OUD) do not receive treatment. Prior research has explored patients' structural barriers to access and perceptions of MOUD. Little research has considered treatment knowledge and perceptions outside of the patient population. Members of the public without OUD themselves (eg, family, friends) can significantly influence treatment decisions of persons with OUD. Considering these gaps, we conducted an original survey with a diverse sample of US adults to explore knowledge and preferences toward OUD treatments.
We conducted an online survey with 1505 White, Black, and Latino/a Americans including a small percentage (8.5%) with self-reported lifetime OUD. The survey used vignettes to describe hypothetical patients with OUD, provide basic treatment information (ie, methadone, buprenorphine, naltrexone, nonmedication treatment), and then assessed treatment preferences. Using multivariable logistic regression, we examined associations between covariates of interest (eg, perceived access, knowledge, demographics) and preference for MOUD versus nonmedication treatment.
There were 523 White, 502 Black, and 480 Latino/a respondents. Across racial/ethnic subsamples, respondents had the greatest knowledge of nonmedication treatments, with Black (72.7%) and Latino/a (70.2%) respondents having significantly greater knowledge compared to White respondents (61.8%). However, after viewing the vignette, a greater proportion of respondents chose methadone (35.8%) or buprenorphine (34.8%) as their first-choice treatment for hypothetical patients. Multivariable logistic regression suggested that among Black respondents, those with knowledge of nonmedication treatment were more likely to choose MOUD than those without knowledge (odds ratio = 2.41, 95% confidence interval = 1.34-4.34). Perceived treatment access did not affect treatment choice.
Across racial groups, knowledge and perceived access to nonmedication treatment was greater than for MOUD, but many still selected MOUD as a first-choice treatment. Significant findings emphasized the importance of treatment knowledge around decision-making, highlighting opportunities for tailored education efforts to improve uptake of evidence-based treatment.
阿片类药物使用障碍（MOUD）的药物治疗是有效的，但大多数阿片类药物使用障碍（OUD）患者未接受治疗。先前的研究已经探讨了患者获得治疗的结构障碍和对 MOUD 的看法。很少有研究考虑 OUD 患者以外的治疗知识和看法。没有 OUD 的公众成员（例如，家人、朋友）可以极大地影响 OUD 患者的治疗决策。考虑到这些差距，我们对美国成年人进行了一项原始调查，以探讨他们对 OUD 治疗的知识和偏好。
我们对 1505 名美国白种人、黑人和拉丁裔/美国人进行了在线调查，其中包括一小部分（8.5%）有自我报告的终生 OUD。该调查使用了病例描述来描述有 OUD 的假设患者，提供基本的治疗信息（即美沙酮、丁丙诺啡、纳曲酮、非药物治疗），然后评估治疗偏好。使用多变量逻辑回归，我们检查了感兴趣的协变量（例如，感知的可及性、知识、人口统计学）与 MOUD 与非药物治疗偏好之间的关联。
有 523 名白人、502 名黑人、480 名拉丁裔/美国人回答了问题。在所有种族/族裔亚组中，受访者对非药物治疗的了解最多，黑人（72.7%）和拉丁裔/美洲人（70.2%）受访者的知识明显多于白人受访者（61.8%）。然而，在观看病例描述后，更多的受访者选择美沙酮（35.8%）或丁丙诺啡（34.8%）作为他们首选的治疗方案。多变量逻辑回归表明，在黑人受访者中，那些对非药物治疗有了解的人比没有了解的人更有可能选择 MOUD（比值比=2.41，95%置信区间=1.34-4.34）。治疗可及性的感知并未影响治疗选择。
在所有种族群体中，对非药物治疗的知识和可及性的了解都大于对 MOUD 的了解，但许多人仍将 MOUD 作为首选治疗方案。重要的发现强调了治疗知识在决策中的重要性，突出了针对特定人群进行教育以提高循证治疗的接受度的机会。
