Research network involvement and addiction treatment center staff: Counselor attitudes toward buprenorphine.
The National Institute on Drug Abuse’s Clinical Trials Network (CTN) aims to improve addiction treatment in the United States in part through technology transfer. Buprenorphine has been the subject of several multi-site clinical trials within the CTN. Two of these trials (CTN-0001 and CTN-0002) showed that buprenorphine was superior to clonidine for opiate detoxification in both inpatient and outpatient treatment settings. A third is examining different buprenorphine tapering schedules during opiate detoxification (CTN-0003), while a fourth is focused on the effectiveness of this medication in adolescents and young adults (CTN-0010).
Given the intense study of buprenorphine within the CTN, this pharmacological innovation offers an opportunity to examine larger organizational processes related to the diffusion of evidence-based treatment practices. This research draws on community-based treatment centers that are part of the larger National Treatment Center Study, a family of longitudinal studies examining changes in service delivery within the American specialty substance abuse treatment system. It compares the attitudes of 561 CTN-affiliated and 1,745 non-CTN-affiliated counselors toward buprenorphine. The data indicated a measurable difference in the perceived acceptability of buprenorphine as a treatment innovation, with CTN-affiliated counselors reported significantly greater acceptability than non-CTN counselors. This difference was not explained by controlling for counselor characteristics, but was completely attenuated by measures of buprenorphine-specific training and buprenorphine implementation.
Because the CTN’s impact on counselor attitudes may be attributed to the greater exposure to buprenorphine received by CTN-affiliated counselors, these data suggest that the benefits of clinical research being conducted in community-based treatment settings may extend beyond demonstrating the effectiveness of an intervention.
Related protocols: CTN-0001, CTN-0002, CTN-0003, CTN-0010