title: Adoption and implementation of medications in addiction treatment programs.
abstract: OBJECTIVE
  Little is known about the extent to which medications are being implemented as routine care in addiction treatment programs. This research describes medication adoption and implementation within the privately funded treatment sector.
  
  
  METHODS
  Face-to-face interviews were conducted with 345 administrators of a nationally representative sample of privately funded substance treatment organizations in the United States.
  
  
  RESULTS
  Rates of adoption of addiction treatment medications in private sector programs were lower than the adoption of psychiatric medications. Even when analyses were restricted to programs with access to physicians, adoption of each addiction treatment medication had occurred in less than 50% of programs. Within adopting programs, implementation was highly variable. While about 70% of patients with co-occurring psychiatric diagnoses received psychiatric medications, rates of implementation of medication-assisted treatment for opioid dependence and alcohol use disorders were just 34.4% and 24.0%, respectively.
  
  
  CONCLUSIONS
  Although previous research has documented higher rates of medication adoption in privately funded treatment programs, this study revealed that both adoption and implementation of pharmacotherapies to treat addiction remains modest. Future research should examine the different types of barriers to implementation, such as physician decision-making, patient preferences, and system-level barriers stemming from financing and public policy.
authors.affiliation: Department of Behavioral Science and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, KY 40536-0086, USA. Hannah.Knudsen@uky.edu
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Abraham
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
mesh_terms: D000427:Alcohol Deterrents / Q000627:therapeutic use; D000437:Alcoholism / Q000534:rehabilitation*; D015897:Comorbidity; D004363:Drug Utilization / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D009294:Narcotics; D011619:Psychotropic Drugs