title: Facilitating factors and barriers to the use of medications in publicly funded addiction treatment organizations.
abstract: OBJECTIVE
  Publicly funded addiction treatment organizations have been slow to adopt pharmacotherapies. Few studies have examined the organizational factors associated with adoption of different types of medication in this treatment sector. This study identifies organization-level facilitators and barriers to the use of medications in publicly funded addiction treatment organizations.
  
  
  METHODS
  Face-to-face interviews with a sample of 318 administrators of a representative sample of publicly funded addiction treatment centers in the US.
  
  
  RESULTS
  Only 23.4% of programs reported using any of the five FDA-approved pharmacotherapies for treating addiction. An additional 14.3% of programs only used medications approved for the treatment of psychiatric disorders. Multivariate multinomial logistic regression results revealed that the odds of adoption of addiction pharmacotherapies were significantly greater in government-owned programs and in programs with more medical personnel. Programs that relied more heavily on non-Medicaid public funding tended to be less likely to adopt addiction treatment medications. Greater contact with pharmaceutical representatives was positively associated with medication adoption.
  
  
  CONCLUSIONS
  Current public funding policies and lack of access to medical personnel are barriers to the adoption of medications by publicly funded addiction treatment organizations. Efforts to promote adoption may also benefit from greater detailing activities by pharmaceutical representatives. These findings suggest that the large research investment devoted to developing addiction treatment medications may have limited public health impact due to the characteristics of publicly funded service delivery system as well as the limited attention given to this system by commercial purveyors of medications.
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, KY 40536-0086, USA. Hannah.Knudsen@uky.edu
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Oser