Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification

Abstract

Objective: An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification.

Method: Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT.

Results: Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT).

Conclusions: Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery.

Trial registration: ClinicalTrials.gov NCT01751789.

Keywords: Heroin dependence; Medication-assisted treatment; Opioid detoxification; Refusal self-efficacy.

Conflict of interest statement

Conflict of Interest

Dr. Bailey reports personal fees from BioDelivery Science International, Inc., grants, personal fees and other from Braeburn Pharmaceuticals, Inc., personal fees from Camurus AB, grants from Orexo, grants and other from Reckitt-Benckiser (Indivior), other from Titan Pharmaceuticals, Inc., outside the submitted work. (ICMJE form available upon request.)

Copyright © 2017. Published by Elsevier Ltd.