A new survey of U. S. primary care physicians has found that 32.9 percent, nearly one third, do not think medication-assisted treatment of opioid use disorder (OUD) is any more effective than other treatment options.
The study, out of Johns Hopkins Bloomberg School of Public Health, also found that nearly one in five doctors, or 20.2 percent, have any interest in treating a patient with opioid use disorder.
Published in the online version of the Annals of Internal Medicine on April 21, the study suggests that while substance abuse professionals have worked to expand medication-assisted treatment of opioid use disorder, some physicians are not only reluctant to view medication-assisted treatment as an option, but also are reluctant to treat opioid use disorder patients at all.
“Expanding treatment for patients with opioid use disorder is a public health priority,” said Beth McGinty, associate professor in the Bloomberg School’s Department of Health Policy and Management and the paper’s lead author. “Primary care physicians present an important opportunity to address the huge gaps in treatment for opioid use disorder in the U.S. It is concerning that so many primary care physicians do not view medication as effective, despite strong research evidence and clinical guidelines emphasizing that treatment with medication saves lives.“
Recent research shows that treating opioid use disorder with methadone, buprenorphine, or naltrexone is more effective in helping addicts recover and preventing overdose deaths than other treatment programs that do not use medication.
The study randomly surveyed 688 U.S. primary care physicians. More than three-quarters of the respondents (77.5 percent) felt that buprenorphine was the most effective treatment medication. But only 7.6 percent of the respondents reported ever having prescribed it. Even fewer (4 percent) reported prescribing naltrexone.
It is estimated that more than 2 million Americans have an opioid use disorder, but that almost two-thirds of those individuals ever receive treatment.
“There are proposals out there to change policies to make it easier for primary care physicians to prescribe medications to treat opioid use disorder,” says McGinty. “Yet we found that the majority of primary care physicians do not support these policies.”
Almost half of the respondents, 47.7 percent, supported prescribing methadone in primary care offices, and less than 40 percent (38 percent) supported changing policies to eliminate waivers necessary currently to prescribe medication-assisted treatments.
However, 81.8 percent supported increasing insurance coverage for medication-assisted treatment of opioid use disorder medication, and 76.4 percent supported increasing government investment in medication-assisted treatment.