Opioid abuse has become a global epidemic and is now a huge public health concern here in the US. Non-medicinal use of opioid prescription drugs is at the forefront of the epidemic and considered the "gateway" drug to other illicit opioid use. As opioid prescribing has increased over the last decade in the US, so has opioid-related deaths, surpassing car accidents and suicide as the leading cause of injury-related deaths. Medication assisted treatment (MAT) is fundamental in decreasing opioid abuse overdose and mortality. Therefore, the research study aims to determine if counseling adherence, opioid abstinence, and retention in MATs are influenced by personal characteristics, socio-economic factors, readiness to change, social support, and integrated care. Guided by social cognitive theory, transtheoretical model, and theory of reasoned action, the study will employ a retrospective cohort design utilizing opioid dependent patients from a MAT Program in West Florida. Analysis of three cox regression models indicated for personal factors: an increase in age was associated with patients being more likely to adhere to counseling (p=.001) and retention (p=.034), full-time employment (p=.043) was positively associated with opioid abstinence, whereas part-time employment (p=.037) was positively associated with retention, having insurance (public: p=.000) was positively associated with counseling adherence, opioid abstinence (public: p=.000, private: p=.035) and retention (public: p=.000, private: p=.000). With regards to environmental influences, social support was positively associated with opioid abstinence (p=.022) and integrated care was positively associated with opioid abstinence (p=.027) and retention (p=.000). Examining these factors are necessary to improve treatment adherence and expand MAT programs. Additionally, providing funding is crucial for practitioners to continually create educational intervention strategies to engage patients in treatment, thereby reducing the opioid overdose epidemic. This study extends the literature contributing to understanding personal factors and environmental influences in MATs.
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Doctor of Philosophy (Ph.D.)
College of Health and Public Affairs
Public Affairs; Health Services Management and Research
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Placide, Vierne, "Examining the Influence of Personal and Environmental Factors on Treatment Outcomes in Opioid Dependent Medication-Assisted Treatment Patients." (2018). Electronic Theses and Dissertations, 2004-2019. 5900.