Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder
Abstract Background Medications for opioid use disorder (MOUD) are among the best tools available to combat the opioid epidemic. Yet, use of MOUD among people with opioid use disorder (OUD) remains low. Interventions to increase MOUD access in the United States have largely focused on improving orga...
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BMC
2025-02-01
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| Series: | Addiction Science & Clinical Practice |
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| Online Access: | https://doi.org/10.1186/s13722-025-00537-2 |
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| author | Nicholas C. Cardamone Rebecca E. Stewart Kyle M. Kampman Steven C. Marcus |
| author_facet | Nicholas C. Cardamone Rebecca E. Stewart Kyle M. Kampman Steven C. Marcus |
| author_sort | Nicholas C. Cardamone |
| collection | DOAJ |
| description | Abstract Background Medications for opioid use disorder (MOUD) are among the best tools available to combat the opioid epidemic. Yet, use of MOUD among people with opioid use disorder (OUD) remains low. Interventions to increase MOUD access in the United States have largely focused on improving organizational capacity and addressing funding barriers, yet stigma toward MOUD may inhibit uptake even where MOUD is readily available. Non-prescribing substance use disorder (SUD) treatment professionals (e.g. counselors) likely have considerable influence on a client’s choice to initiate and adhere to MOUD, but beliefs that counselors convey about MOUD in interaction with clients are understudied. The current study explores what advantages and disadvantages that counselors communicate about buprenorphine, methadone, and naltrexone. Methods From June to December 2021, we surveyed counselors from publicly-funded SUD treatment agencies under a municipality-wide mandate to offer MOUD to all clients with OUD. Counselors were asked to describe, in a free-response format, the most important advantages and disadvantages to communicate to their clients about taking buprenorphine, methadone, and naltrexone. Counselor responses were coded for one or more advantage and disadvantage. Results A total of 271 SUD counselors from 29 agencies in the Philadelphia Metropolitan Area completed the survey, generating 1,995 advantages and disadvantages across three types of MOUD. The most frequently reported advantage across all three types of MOUD was their ability to reduce cravings and illicit drug use. The most frequently reported disadvantage related to the potential for some types of MOUD to develop long-term medication dependence. Conclusions As the availability and variety of MOUD treatment options continue to expand, it is important that SUD counselors are equipped with evidence-based recommendations for OUD care. We identified misalignments with the MOUD-prescribing evidence base and stigmatizing language toward MOUD within counselors’ responses, highlighting the potential to refine training materials for MOUD and mitigate stigmatizing beliefs. |
| format | Article |
| id | doaj-art-e8438ffe14184195bda392fb37663576 |
| institution | Kabale University |
| issn | 1940-0640 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj-art-e8438ffe14184195bda392fb376635762025-02-09T12:49:14ZengBMCAddiction Science & Clinical Practice1940-06402025-02-012011810.1186/s13722-025-00537-2Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorderNicholas C. Cardamone0Rebecca E. Stewart1Kyle M. Kampman2Steven C. Marcus3Department of Psychiatry, University of Pennsylvania, Perelman School of MedicineDepartment of Psychiatry, University of Pennsylvania, Perelman School of MedicineDepartment of Psychiatry, University of Pennsylvania, Perelman School of MedicineSchool of Social Policy and Practice, University of PennsylvaniaAbstract Background Medications for opioid use disorder (MOUD) are among the best tools available to combat the opioid epidemic. Yet, use of MOUD among people with opioid use disorder (OUD) remains low. Interventions to increase MOUD access in the United States have largely focused on improving organizational capacity and addressing funding barriers, yet stigma toward MOUD may inhibit uptake even where MOUD is readily available. Non-prescribing substance use disorder (SUD) treatment professionals (e.g. counselors) likely have considerable influence on a client’s choice to initiate and adhere to MOUD, but beliefs that counselors convey about MOUD in interaction with clients are understudied. The current study explores what advantages and disadvantages that counselors communicate about buprenorphine, methadone, and naltrexone. Methods From June to December 2021, we surveyed counselors from publicly-funded SUD treatment agencies under a municipality-wide mandate to offer MOUD to all clients with OUD. Counselors were asked to describe, in a free-response format, the most important advantages and disadvantages to communicate to their clients about taking buprenorphine, methadone, and naltrexone. Counselor responses were coded for one or more advantage and disadvantage. Results A total of 271 SUD counselors from 29 agencies in the Philadelphia Metropolitan Area completed the survey, generating 1,995 advantages and disadvantages across three types of MOUD. The most frequently reported advantage across all three types of MOUD was their ability to reduce cravings and illicit drug use. The most frequently reported disadvantage related to the potential for some types of MOUD to develop long-term medication dependence. Conclusions As the availability and variety of MOUD treatment options continue to expand, it is important that SUD counselors are equipped with evidence-based recommendations for OUD care. We identified misalignments with the MOUD-prescribing evidence base and stigmatizing language toward MOUD within counselors’ responses, highlighting the potential to refine training materials for MOUD and mitigate stigmatizing beliefs.https://doi.org/10.1186/s13722-025-00537-2Medications for opioid use disorderOpioid use disorderSubstance use disorder counselorsStigmaMOUD |
| spellingShingle | Nicholas C. Cardamone Rebecca E. Stewart Kyle M. Kampman Steven C. Marcus Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder Addiction Science & Clinical Practice Medications for opioid use disorder Opioid use disorder Substance use disorder counselors Stigma MOUD |
| title | Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| title_full | Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| title_fullStr | Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| title_full_unstemmed | Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| title_short | Perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| title_sort | perspectives of substance use disorder counselors on the benefits and drawbacks of medications for opioid use disorder |
| topic | Medications for opioid use disorder Opioid use disorder Substance use disorder counselors Stigma MOUD |
| url | https://doi.org/10.1186/s13722-025-00537-2 |
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