Opioid-dependence treatment in the era of recovery: insights from a UK survey of physicians, patients and out-of-treatment opioid users

Abstract

Background: Project Access UK was designed to provide real-world observations on the status of medication-assisted treatment (MAT) of opioid dependence.

Methods: 544 respondents from three groups (physicians, patients in MAT and out-of-treatment users) were interviewed or completed questionnaires.

Results: Patient reasons for seeking treatment included ending their dependence and improving their health and well-being. Patients and users reported a mean of 4.0 versus 2.7 prior MAT episodes, but patient awareness of the main treatment options varied from 94% for methadone to 46% for buprenorphine–naloxone. Among patients, 49% requested a specific medication (mostly methadone) and 78% of requests were granted. Forty percent of patients were not currently receiving psychosocial or key- working support. Daily supervised dosing was most commonly cited as a condition of staying in treatment with the biggest impact on daily life (36%). Among patients, 56% continued to use illicit drugs on top of their MAT and few (7%) were in employment. The majority of patients (56%) and users (51%) had been in prison (an average of 6.8 times).

Conclusion: Patients are motivated to recover. However, the full range of evidence-based interventions are not fully utilised and many patients cycle repeatedly through periods of treatment, relapse and imprisonment.

• Opioid-dependence
• recovery
• survey

Acknowledgements

We wish to thank the participating individuals, treatment providers and support centres who contributed to this study. The original questionnaires were designed by Professor Heino Stöver. Financial support for implementation of the survey and writing of this manuscript was provided by Reckitt Benckiser Pharmaceuticals. Data were collected by Synovate Healthcare and medical writing support was provided by Real Science Communications. The authors analysed and interpreted the data, critically reviewed the manuscript and had final responsibility for the decision to submit for publication.