Buprenorphine Maintenance Treatment of Opiate Dependence: Correlations Between Prescriber Beliefs and Practices

Abstract

Background: Despite the existence of evidence-based guidelines, different prescriber practices around buprenorphine maintenance treatment (BMT) of opiate dependence exist. Moreover, certain prescriber beliefs may influence their practice patterns.

Objective: To understand community BMT practice patterns and discern their relationship to practitioner beliefs.

Method: Survey of 30 local BMT prescribers about aspects of BMT, and analysis of correlations between practices and practitioner beliefs.

Results: Practitioners generally followed standard treatment guidelines, though the most-common maintenance dosages of BMT (4-12 mg) were lower than recommended by some studies. Endorsement of belief in a "spiritual basis" of addiction correlated with lower average BMT doses and less frequent endorsement of the belief that BMT-treated patients are "in recovery."

Conclusions/importance: These data suggest that relatively standardized, longer-term BMT of opiate dependence is accepted among the majority of surveyed prescribers, and certain provider beliefs about addiction may influence prescribing habits and attitudes. Future studies should: (1) assess these findings in larger samples; (2) examine how prescriber beliefs about addiction and BMT compare with those of other addiction treatment providers; and (3) ascertain whether individual prescriber beliefs influence patient outcomes.

Keywords: Opiate dependence; buprenorphine; psychopharmacology; stigma.