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Buprenorphine in office-based opioid treatment: barriers, beliefs and benefits

Coughlen, Jordan (2019) Buprenorphine in office-based opioid treatment: barriers, beliefs and benefits. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Over 50 Americans die each day from an acute opioid overdose. In 2015, over 52,000 people died from a drug overdose. Given the gravity of the opioid epidemic within the United States, effective and expansive treatment methods are necessary to adequately address and reduce the impact of Opioid Use Disorders (OUD).
Purpose: Opioid-agonist-based medication assisted treatment is the most effective pharmacological intervention to treat OUD. Unlike methadone, which is limited to specialized clinic settings, buprenorphine is a long-acting partially synthetic opioid medication approved for the treatment of Opioid Use Disorders since 2002. Despite the effectiveness of this pharmacological intervention and approval within office-based settings, like primary health centers, delivery of buprenorphine medication remains limited. The purpose of this literature review is to identify and synthesize the barriers to, beliefs surrounding, and benefits of incorporating office based opioid treatment (OBOT) in non-MAT specific settings.
Methods: A literature search was conducted within PubMed to identify relevant peer-reviewed papers. Boolean search terminology was used, and the search was limited to papers published within the last five years.
Results: Eight relevant articles were identified, which included qualitative and mixed-method studies. Literature revealed several barriers to buprenorphine treatment implementation including: concerns surrounding staff abilities, strict federal oversight, low perception of need for treatment, limited training within residency curricula, and stigma surrounding substance use. Beliefs discovered include the ideas that: patients with OUD are stressful and challenging, providers’ self-perceptions that they are ill-equipped to meet patient needs, buprenorphine is “trading” addictions, and there is not enough time to treat individuals with OUD in clinical settings. Perceived benefits of implementation include a sense of satisfaction for being a part of the solution and the reward of watching a patient and their family heal. Given the gravity of the opioid epidemic within the United States, these findings have public health significance, as the research reviewed indicates major barrier to buprenorphine OBOT expansion and service provision.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Coughlen, Jordanjac397@pitt.edujac387
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHawk,
Committee MemberEngel,
Committee MemberFelter,
Date: 30 January 2019
Date Type: Publication
Defense Date: 7 December 2018
Approval Date: 30 January 2019
Submission Date: 26 November 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 71
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Office-based, buprenorphine, medication assisted treatment, barriers, united states, opioid dependance, opioid use disorder
Date Deposited: 30 Jan 2019 18:39
Last Modified: 30 Jan 2019 18:39


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