title: Barriers to use of pharmacotherapy for addiction disorders and how to overcome them.
abstract: Substance use disorders are highly prevalent, debilitating conditions for which effective pharmacotherapies exist with a broad evidence base, yet pharmacotherapy for the treatment of addiction disorders is underutilized. The goals of this review are to describe the barriers that may contribute to poor adoption and utilization of pharmacotherapy for alcohol and opioid dependence at the system, provider, and patient level and to discuss ways to overcome those barriers. Multifaceted efforts directed at all three levels may be needed to speed pharmacotherapy adoption. More research is needed to help us better understand barriers from patients' perspectives. Strategies to promote adoption of pharmacotherapy for addiction disorders should be modified to fit the needs of the practice, system, and individual patients. Pharmacotherapy is a valuable tool in the clinical armamentarium of addiction treatment; thus, overcoming barriers to implementation may improve clinical and social outcomes.
authors.affiliation: Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA. elizabeth.oliva@va.gov
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Oliva
authors.forename: Natalya C
authors.initials: NC
authors.lastname: Maisel
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
mesh_terms: D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011320:Primary Health Care / Q000592:standards
chemical_list: D000427:Alcohol Deterrents; D000701:Analgesics, Opioid; D009292:Narcotic Antagonists