2015 John S. Toll Summer Science Program Student Presentation

1. The Prevalence of Medically Assisted Treatment
and of Associated Attitudes in
Maryland Oxford Houses
Emily Stecker and Dr. Christopher Beasley
Department of Psychology
Washington College
Abstract
This study aimed to identify and quantify the experienced
and perceived stigma of medically assisted therapy in
Oxford Houses across Maryland. The goals of this
investigation were to describe the prevalence of MAT in
Oxford Houses, identify the degree to which MAT patients
disclose their treatments to their Oxford Houses, and
explain willingness to accept MAT members among Oxford
Houses. Overall, the results of the study indicated that a
third of residents have negative attitudes toward medically
assisted treatment.
Introduction
• In Baltimore, MD from 1995 to 2009, the number of
overdose deaths attributed to heroin were between
106 (2008) and 312 (1999) (Schwartz et al., 2013).
• 7,479 patients were treated with buprenorphine
(Suboxone) in Baltimore in 2009 (Schwartz et al., 2013).
• Greater access to opioid agonist treatment is associated
with a decrease in deaths from heroin overdose
(Schwartz et al, 2014).
• Of patients receiving methadone-treatment (MT),
buprenorphine-treatment (BT), and out-of-treatment
(OT), all patients have more positive attitudes toward
buprenorphine than methadone. The BT group have
more positive attitudes toward buprenorphine than do
the MT and OT groups (Kelly et al., 2012).
• Oxford Houses are democratic, self-run addiction
recovery homes (Oxford House, Inc. 2011). As of 2015,
there are 1,900 individual Houses internationally
(Oxford House, Inc. 2015).
Objectives
• Describe prevalence of buprenorphine in Maryland
Oxford Houses.
• Identify residents’ disclosure of buprenorphine
treatment to their respective Houses.
• Explain willingness of Oxford House residents to vote in
residents being treated with buprenorphine.
• Determine attitudes toward buprenorphine in
Maryland Oxford Houses.
Methods
Participants: Maryland Oxford House residents (N=89)
• 73% male
• 51.7% White/not of Hispanic origin, 42.7% Black, 1.4% Hispanic
• 25.8% ages 20-29, 27.3% ages 30-39, 11.3% ages 40-49, 30.2% ages 50-59,
4.3% ages 60-69
• 6.7% completed 9th-10th grade, 23.6% GED/High school, 5.6% trade school,
47.2% some college, 7.9% undergraduate degree, 5.6% graduate degree
Measures: The survey was composed of measures of experienced MAT stigma-
related rejection, MAT perceived stigma in the recovery community, and MAT-related
shame. A resident is determined to be participating in MAT if he or she discloses in
the questionnaire that he or she is currently taking methadone, buprenorphine
(Suboxone or Subutex), or naltrexone (Vivitrol).
Discussion
• Nearly 15% of respondents are currently using MAT
• Less than a quarter of those using MAT disclose their treatment in
their recovery meetings.
• Approximately two-thirds of respondents would consider voting in a
resident that uses MAT.
• About four-fifths of respondents perceive the recovery community to
have positive attitudes toward MAT.
Limitations: Low rates of participation, self-report methods, and missing
data.
Future Directions:
• National survey of prevalence of MAT in Maryland Oxford House
• Study of how attitudes toward MAT affect success.
• Measure of success of MAT patients placed in Oxford Houses.
Conclusions:
• A majority of residents in Oxford Houses perceive the recovery
community to be accepting of MAT.
• A considerable majority of those using MAT do not feel out of place in
the recovery community.
• A majority of MAT patients do not disclose their treatment in recovery
meetings.
• Oxford House residents are not adamantly opposed to residents using
MAT as a form of recovery treatment.
Figure 1.
Visual representation of
respondents’ answers to
question: Do you
receive medication
assisted treatment
(MAT) for opioid
dependence.
References
Kelly, S. M., Brown, B. S., Katz, E. C., O'Grady, K. E., Mitchell, S. G., King, S., & Schwartz, R. P.
(2012). A Comparison of Attitudes Toward Opioid Agonist Treatment among Short-Term
Buprenorphine Patients. American Journal Of Drug & Alcohol Abuse, 38(3), 233-238.
doi:10.3109/00952990.2011.643983
Luoma, J. B., O'Hair, A. K., Kohlenberg, B. S., Hayes, S. C., Fletcher, L. (2010). The development
and psychometric properties of a new measure of perceived stigma toward substance
users. Substance Use and Misuse, 45, 47-57.
Oxford House, Inc. (2011). Oxford House Manual, (4). Silver Spring, MD: Oxford House, Inc.
Oxford House, Inc. (2015). 2015 Annual Oxford House World Convention. Retrieved from:
www.oxfordhouse.org
Schwartz, R. R., Gryczynski, J., O'Grady, K. E., Sharfstein, J. M., Warren, G., Olsen, Y., & ... Jaffe, J.
H. (2013). Opioid Agonist Treatments and Heroin Overdose Deaths in Baltimore, Maryland,
1995-2009. American Journal Of Public Health, 103(5), 917-922.