A Quantitative Examination of Illness Models Among People With Opioid Use Disorder Receiving Methadone Treatment

Marina Gaeta Gazzola; Iain D Carmichael; Emma Thompson; Mark Beitel; Lynn M Madden; Gul Saeed; Kim Hoffman; Muhammad Hammouri; Connie Hsaio; Declan T Barry

doi:10.1097/ADM.0000000000001282

A Quantitative Examination of Illness Models Among People With Opioid Use Disorder Receiving Methadone Treatment

J Addict Med. 2024 Mar 6. doi: 10.1097/ADM.0000000000001282. Online ahead of print.

Authors

Marina Gaeta Gazzola¹, Iain D Carmichael, Emma Thompson, Mark Beitel, Lynn M Madden, Gul Saeed, Kim Hoffman, Muhammad Hammouri, Connie Hsaio, Declan T Barry

Affiliation

¹ From the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (MGG, MB, CH, DTB); The APT Foundation, Inc., New Haven, Connecticut (MGG, ET, MB, LMM, CH, DTB); Department of Emergency Medicine, NYU Langone School of Medicine/NYC Health and Hospitals Bellevue, New York, New York (MGG); Department of Statistics, University of California at Berkeley, Berkeley, California (IDC); Department of Pathology and Laboratory Medicine, University of California at San Francisco School of Medicine, San Francisco, California (IDC); Rutgers New Jersey Medical School, Rutgers, New Jersey (ET); Department of Internal Medicine, Oregon Health and Science University, Portland OR (KH); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (LMM, GS); Child Study Center, Yale School of Medicine, New Haven, Connecticut (MB, DTB); and University of Jordan, Amman, Jordan (MH).

PMID: 38446859
DOI: 10.1097/ADM.0000000000001282

Abstract

Background: Few studies have examined illness models among people with addiction. We investigated illness models and their associations with demographics and treatment beliefs among patients receiving methadone treatment for opioid use disorder.

Methods: From January 2019 to February 2020, patients receiving methadone treatment at outpatient opioid treatment programs provided demographics and rated using 1 to 7 Likert-type scales agreement with addiction illness models (brain disease model, chronic medical condition model [CMCM], and no explanation [NEM]) and treatment beliefs. Pairwise comparisons and multivariate regressions were used to examine associations between illness models, demographics, and treatment beliefs. Statistical significance was set at P < 0.05.

Results: A total of 450 patients participated in the study. Forty percent self-identified as female, 13% as Hispanic, and 78% as White; mean age was 38.5 years. Brain disease model was the most frequently endorsed illness model (46.2%), followed by CMCM (41.7%) and NEM (21.9%). In multivariate analyses, agreement with brain disease model was significantly positively associated with beliefs that methadone treatment would be effective, counseling is important, and methadone is lifesaving, whereas agreement with CMCM was significantly positively associated with beliefs that methadone treatment would be effective, counseling is important, 12-step is the best treatment, taking methadone daily is important, and methadone is lifesaving. In multivariate analyses, agreement with NEM was negatively significantly associated with beliefs that methadone would be effective, counseling is important, taking methadone daily is important, and methadone is lifesaving.

Discussion: Many patients in methadone treatment endorsed medicalized addiction models. Agreement with addiction illness models appear to be related to treatment beliefs.