Barriers to opioid substitution treatment access, entry and retention: a survey of opioid users, patients in treatment, and treating and non-treating physicians.
OBJECTIVE
Although the number of patients in opioid substitution treatment (OST) in Germany has increased in recent years, many dependent opioid users remain out of treatment. Project IMPROVE assessed attitudes and beliefs regarding barriers to OST.


METHODS
Data were collected from opioid-dependent individuals (using self-complete questionnaires) currently in treatment (n = 200) or not in treatment (n = 200), and OST-accredited physicians (using computer-aided telephone interviewing) who currently provided (n = 101) or did not provide OST (n = 51) from different regions in Germany.


RESULTS
Key results showed that OST was perceived as valuable and effective by physicians, patients and users but that OST access and provision were inadequate, especially outside of major cities.


CONCLUSIONS
These findings are consistent with national data indicating a worsening imbalance between patient demand for treatment and the supply of available physicians accredited to provide it. Many physicians and patients were not aware of, or were not utilizing, therapeutic strategies that may help reduce misuse and diversion. Improvements in the regulatory framework for OST, and identifying additional sources of support and training, would encourage more accredited physicians to actively provide treatment and thus help to fully realize the benefits of currently available treatment options.
Faculty of Health and Social Work, University of Applied Sciences, Frankfurt, Germany. hstoever@fb4.fh-frankfurt.de
Heino
H
Stöver
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D010820:Physicians / Q000706:statistics & numerical data; D016312:Treatment Refusal / Q000706:statistics & numerical data