A Quality Improvement Project: Reducing Stigma of Opioid Addiction and Its Treatment Through Education Initiatives

Abstract

Purpose: Medications for opioid use disorder (MOUD) are considered the standard of care for substance use disorder (SUD); however, the literature reveals a significant underutilization of this treatment. The medications work to reduce acute withdrawal symptoms and opioid cravings to prevent hazardous drug use, subsequently resulting in a reduction in overdose and secondary diseases and injuries related to high-risk behavior when under the influence of substances. A quality improvement project was designed to educate staff at a local prison on addiction and treatment involving MOUD in the context of a recently implemented program including buprenorphine. Background: OUD is a prevalent issue amongst those incarcerated, with high rates of return to use and overdose upon reentry to the community. MOUD/MAT programs have increased in correctional settings but still fall short of meeting the current needs of this population. Stigma surrounding addiction can lead to delayed access in treatment and plays a role in an individual’s continued use. Methods: Both clinical and correctional staff were recruited through email with participation occurring over the course of 10 days. Some 23 participants completed the pre- and post-surveys in their entirety and were included in the results analysis. Results: There was evidence of improved knowledge regarding the statistics and neurobiology of addiction as well as influential factors of addiction related to the social determinants of health model. The open-ended questions provided staff the opportunity to share their perceived barriers in administering MOUD to inmates which varied in response, from no concerns or non-applicability to their job function to concerns with the safety of the program related to diversion and subsequent misuse of the medication. Conclusion: The educational intervention provided staff at a local prison with evidence-based information surrounding the use of MOUD. Based on staff feedback, there may be an opportunity for further exploration of potential contributing factors in medication diversion. The literature highlights diversion as a legitimate concern, however, protocols exist in prevention strategies including staff administration process, and route of medication being considered for the uniqueness of the correctional facility needs.