In search of a silver lining: Perspectives of Physicians Who Treat Opioid Use Disorder with Medication Assisted Treatment

Medication-assisted treatment (MAT) is recognized by SAMHSA, the Veterans Administration, and the World Health Organization as an effective, evidence-based intervention in the treatment of opioid dependence, but in West Virginia where opioid overdose death rates rose last year to 1,008 (up from 887 in 2016), physicians’ implementation of MAT has been slow.

This qualitative study explores the perspectives and experiences of six physicians in West Virginia who treat patients with Opioid Use Disorder (OUD) using Buprenorphine, often referred to as medication-assisted treatment (MAT). Semi-structured individual interviews lasting one hour were the primary source of information for understanding the experiences of prescribing physicians in the state.

Research questions include 1) What are the most significant experiences influencing prescribing doctors’ decisions to provide MAT? 2) What barriers, if any, must doctors overcome to become an MAT prescribing physician? 3) How do physicians overcome those barriers? and 4) How might doctors’ perspectives inform teaching and learning in medical school and continuing education curriculum? Analysis of content from the interviews occurred using four conceptual frameworks i.e. phenomenology, applied research, pragmatism, and strengths perspective to identify major themes.

Findings from the interviews reveal barriers to MAT implementation and suggest strategies for overcoming addiction stigma within medical culture. New approaches to relationship building with patients suffering from addiction disorders highlighted in the research deviate from the medical model of treatment by recognizing the effect of psychological, social, and environmental factors on patients’ behaviors and the effect of behavior on wellness. The social model of medicine useful in the treatment of addiction disorders is applicable to the treatment of chronic diseases like diabetes, cancer, heart disease, and pain management that are so prevalent in Appalachia.