5300.0: Wednesday, November 15, 2000 - 9:06 PM

Abstract #15671

A Three-state study of barriers to adoption of naltrexone in alcoholism treatment

Cindy Thomas, PhD1, Stanley Wallack, PhD1, Linda Simoni-Wastila, RPh, PhD1, Dennis McCarty, PhD1, Christine E. Bishop, PhD1, and Robert Swift, MD2. (1) Brandeis University Schneider Health Policy Institute, Heller Graduate School, 415 South Street, Waltham, MA 02454, 781-736-3921, cthomas@brandeis.edu, (2) Department of Psychiatry, Brown University, Chalkstone Avenue, Providence, RI

Recent advances in understanding the physiology of alcoholism and other addictions have led to the development of new therapies. However, the contribution of these new therapies depends upon their being adopted into clinical practice. One medication recently approved for alcoholism treatment, naltrexone (Revia‚), is not widely used, even though its use was supported by an AHCPR evidence report, SAMHSA treatment protocols, and NIAAA recommendations. This paper examines in sevaral states what types of clinicians have chosen to adopt naltrexone, and why, and compares results across states. Physicians and nonphysicians in Massachusetts, Tennessee, and Washington were surveyed to examine attitudes and practices regarding use of naltrexone and other medications in treating alcoholism. Clinicians rated reasons for their decision to prescribe or recommend naltrexone or not. Logistic regression tested the contribution of clinician characteristics and reasons associated with adoption. Response rate was 64% overall (1220/1925). Over half of physicians prescribe naltrexone occasionally or more. Over half of nonphysicians never recommend it. Use differs by clinical setting and organizational policies. For both physicians and nonphysicians, the most important barriers to adoption of naltrexone are insufficient knowledge about it, and cost of therapy. For those who prescribe or recommend naltrexone, main reasons are a belief in its effectiveness and good experience in the past with clients taking it. Most clinicians (adopters and nonadopters), believe that medications can play an important role in treating alcohol abuse. However, fewer than half of all clinicians in each state regularly prescribe or recommend naltrexone.

Learning Objectives: At the conclusion of the session, the participant will be able to identify barriers to adoption of new treatments for alcoholism and assess potential interventions to improve technology transfer in this area

Keywords: Alcoholism, Alcohol Use

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA