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Including individuals in medication assisted recovery into recovery residences

Brewer, Julie (2019) Including individuals in medication assisted recovery into recovery residences. Master Essay, University of Pittsburgh.

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Abstract

Background: Those whose primary drug of choice is opioids have the poorest treatment outcomes of all individuals with substance use disorders (SUD). Medication assisted treatment, generally consisting of some type of drug replacement medication combined with behavioral therapy, is currently considered to be best practice for those with long-term Opioid Use Disorder (OUD). While this is widely recognized in the medical community, recovery residences (RRs), which are largely organic and unregulated, cling to abstinence-only models. This has created a gap in housing services that has exacerbated an already serious public health issue both by limiting the capacity of available housing and by limiting the number of individuals willing to be treated by drug replacement medications because of housing concerns.
Methods: In order to understand attitudes toward medication-assisted recovery (MAR), the logistics of including individuals in MAR into RRs, and regulations governing RRs, the professional experience, perceptions, and understanding of 7 key informants was obtained through semi-structured interviews. The qualitative data gained through this process was analyzed for themes that were compared and contrasted.
Results: The results of this study have important public health significance as they can be used to develop both standards for and studies of RRs. The results make clear that there is definite bias against individuals who participate in MAR by both providers of SUD services and peers in RRs. MAR is not viewed as a viable recovery pathway and is often seen merely as a steppingstone to abstinence. Participants reported that it is widely believed that individuals in MAR impact their peers negatively, although no evidence has been found to support this. This study also makes clear that there is serious concern about diversion of medications used to treat SUD, but there are a number of ways this concern can be mitigated. Lack of regulation of RRs has led to an environment that varies widely. It is feared that recently proposed guidelines in Pennsylvania may have a number of unintended consequences and do little to help those in MAR to secure safe, stable housing.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Brewer, Juliejub49@pitt.edujub49
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHawk, Marymeh96@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberGreeno, Catherinekgreeno@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 11 December 2019
Date Type: Submission
Submission Date: 11 December 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 46
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Medication Assisted Recovery, Addiction, MAT, Recovery Houses, Recovery Residences
Date Deposited: 11 Mar 2020 21:20
Last Modified: 11 Mar 2020 21:20
URI: http://d-scholarship.pitt.edu/id/eprint/38010

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