Amid national overdose epidemic, treatment rates remain concerningly low, indicating significant barriers to care

Military veterans often experience distinct health issues and disparities that can heighten their vulnerability to opioid use, increasing their risk for opioid use disorder and overdose. Yet despite the heightened risk, nearly 60 percent of veterans with the disorder do not receive effective treatment.

While medications like buprenorphine are readily available to treat OUD, their use among veterans is low. Stigma has been identified as a barrier to medication treatment—impacting both treatment decisions and patient experiences. Unfortunately, research into the specific impact on veterans is limited, as previous studies have primarily focused on the general population or surveyed physicians who do not commonly prescribe medication treatment for opioid use disorder.

However, Rachel Girard, a doctoral candidate in psychology at the University of Rhode Island, has launched a study aimed at increasing understanding of the stigma factors that affect medication treatment access and utilization among veterans—and how stigma may influence clinicians’ treatment decisions.

Girard’s study is funded by an F31 grant from the National Institutes of Health, a training grant that enables students to develop into independent research scientists while obtaining mentored training. She is examining data from a sample of Veterans Health Administration physicians who have prescribed buprenorphine to examine clinician characteristics, attitudes, and prescribing practices. The data includes interviews from a sample of veterans who suffer with OUD exploring the barriers they face.

“This project is significant in its goal to identify potential targets for interventions that reduce stigma and increase access to medication treatment for OUD for veterans,” Girard wrote in a project description. “This project is innovative in its use of an expansive mixed-methods approach that captures both clinician and patient perspectives to understand how stigma factors impact OUD treatment.”

The study will develop profiles of buprenorphine prescribers and patients to gain an understanding of how treatment decisions were made, based on patient conditions with varying complexities and comorbid conditions. It also examines veterans’ perceptions and experiences with stigma regarding OUD treatment. The study, contextualized by patient perceptions, will link clinician stigma factors related to medication-assisted treatment approaches, and provide guidance as to where stigma reduction interventions may be most needed. Girard aims to offer advice to address medication-assisted treatment for OUD (MOUD) at the individual and community levels.

“Previous research on stigma related to MOUD has surveyed clinicians who don’t prescribe MOUD. Additionally, we have a limited understanding of how comorbid substance use may compound stigma and influence clinicians,” Girard wrote. “Beliefs about medication treatment for OUD and treatment decisions is a crucial question, given the increasing rates of overdose involving multiple substances.”