A systems perspective of buprenorphine patients' experiences in an opioid treatment program

Abstract

There is a significant gap between the treatment need of individuals in the United States with opioid use disorders and the treatment capacity to offer methadone or buprenorphine-based pharmacotherapy. This dissertation utilizes an ecological systems framework to explore buprenorphine patients’ experiences in an opioid treatment program, and discover potential barriers to patients’ treatment entry and engagement. Data comes from semi-structured qualitative interviews (n=20) with buprenorphine patients receiving daily medication doses in an opioid treatment program modality. Findings indicate a continued paradigmatic division between the criminalization and medicalization of opioid use disorders that filters down through ecological systems levels to create policy inconsistencies and individual treatment entry and engagement barriers. These findings contribute to existing research that has sought to understand the opioid treatment gap from the perspective of physicians and treatment organizations, by including patient perspectives of barriers limiting accessibility to buprenorphine. The results of this research project encourage the development of innovative strategies and interventions to improve the accessibility of buprenorphine in a treatment system that significantly improved its availability in recent years.