Young adults are more skeptical than older adults about medications for substance use disorder like buprenorphine. This study examined factors that may help clarify these attitudes in a unique sample of young adults – individuals enrolled in a collegiate recovery program.
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There are several FDA-approved medications for substance use disorders, such as buprenorphine/naloxone and methadone for opioid use disorder, and naltrexone, acamprosate, and disulfiram for alcohol use disorder. Despite their utility, younger individuals tend to have more negative attitudes toward them and toward psychotropic medications more generally. With respect to opioid agonist medications, in particular, young adults may encounter negative views from peers, which could impact their willingness to take or continuing taking these medications.
Collegiate recovery communities are designed to help prevent relapse and enhance academic success for young adults with recovery from substance use disorder through specialized programming and robust peer and staff support. Given their growing presence across US universities, collegiate recovery students are important stakeholders in efforts to understand and address young adult attitudes toward substance use disorder medications. This is especially relevant given dynamic policy shifts to accommodate multiple pathways to recovery including efforts to help individuals taking agonist medications, longer-acting opioids associated with reduced opioid use and overdose risk.
Investigating the medication use and attitudes of collegiate recovery program affiliates holds promise to guide interventions to overcome barriers to accessing these collegiate resources, especially among young adults with substance use disorders. The findings may illuminate ways to boost medication adoption within these communities and for young people with substance use disorder more generally. This study examined substance use disorder medication attitudes across collegiate recovery programs from 43 US universities.
This was a cross-sectional study of 162 students in 43 collegiate recovery programs designed to understand why these students might consider taking, or encourage others to consider taking, medications to manage substance use disorders. Drawing on the Theory of Planned Behavior, which suggests that intentions guide actions and are shaped by attitudes, social norms, and perceived control, the study aimed to uncover the factors influencing students’ decisions.
Participants responded to several survey questions intended to assess their attitudes toward and acceptance of medications for substance use disorder. The study examined predictors of three variables related to substance use disorder medication intentions: 1) their own intention to use medication; 2) their perceived acceptability of medications; and 3) their willingness to encourage others to use medications. For each survey item, students provided a rating on a scale from 1 (unlikely or unacceptable) to 7 (likely or acceptable).
Specifically, controlling for variables including gender, mutual-help participation, drug of choice, current addiction medicine use, knowledge of addiction medicine, year in collegiate recovery program, analyses tested whether participants’ attitudes were associated with these intentions. Then also accounting for these attitudes, analyses tested whether social norms were associated with these intentions. To understand the influence of social norms, the survey asked students to rate how much they felt supported by significant others in their decision to take these medications and gauged the openness and attitudes of other students, as well as the collegiate recovery program staff towards these medications.
The median age of the sample participants was 25 years old (mean = 27), with participants ranging from 18 to 56 years old. The group was 56% male, and 35% were graduate students. Most participants identified as White (83%), with smaller representations of Bi-/Multiracial (9%), Asian American (3%), African American (2%), and Hispanic (1%). On average, students had been enrolled in a collegiate recovery program for 1.5 years and had undergone nearly 2 prior treatments for substance use disorder. Three-fourths had a history of substance use disorder treatment.
Students generally considered these medications moderately acceptable, with an average rating of 4.88 out of 7. Despite this moderate acceptability, the intent to use these medications was low, with an average rating of 1.88 out of 7. The willingness to encourage others to use these medications was also moderate, with an average rating of 3.18 out of 7.
Acceptance by important others predicts intent to use and to encourage use of substance use disorder medications
Examining students’ likelihood of using medications for substance use disorders showed that once perceived social norms were factored in, the direct influence of beliefs regarding medication effectiveness on intent to use faded, while acceptance by important others remained a strong predictor. Feeling that important others accept medications for substance use disorder explained 14% of intent to use these medications and 3% of encouragement to others to use them.
Positive attitudes toward substance use disorder medications predict acceptability and encouragement
After accounting for social influences, students’ positive attitudes towards medications for substance use disorders and their belief in their effectiveness consistently correlated with greater acceptance of their use. When individuals personally hold positive views towards medications for substance use disorders, it significantly impacts their acceptance of these treatments, and their tendency to promote them among others. Having a positive attitude towards medications for substance use disorder explains 49% of medication acceptability and 38% of encouragement to others to use them.
Perceived effectiveness of substance use disorder medications predicts acceptability and encouragement
Believing in the effectiveness of medications for substance use disorder explains 40% of medication acceptability and 33% encouragement to others to use them.
This study examined factors influencing students’ decisions to take and recommend to their peers medications for substance use disorders. The researchers examined these factors in light of three key dimensions that were adapted from the Theory of Planned Behavior, namely, the students’ attitudes toward these medications, their intentions to use them, and their willingness to recommend that others use them.
The study found that students with positive attitudes towards these medications were more likely to find these medications acceptable and to encourage their peers to take them. This finding makes sense in light of what we already know about the impact of negative attitudes and stigma as barriers to starting and maintaining medication treatment for opioid use disorder within different treatment contexts, such as healthcare settings and recovery community centers. Other research has shown that people may perceive negative message about these medications when attending mutual-help groups, such as Alcoholics Anonymous or Narcotics Anonymous; though such messages may come from a small, albeit influential, group of individuals. It was surprising, then, that in the present study there was no unique effect of participation in mutual-help groups on the intention to use these medications. It is possible that the specific measure used to evaluate their participation (a single question asking: “Have you ever considered yourself a member of a mutual-help group?”) was not nuanced enough to establish the unique influence of these groups on medication attitudes. What this finding adds to our broader understanding is the relevance of attitudes to the acceptability of these medications within the specific context of collegiate recovery programs. The implications are that increasing the use and acceptability of this type of treatment requires improving the medication-related attitudes among individuals within this population.
The study also found that students’ intent to use medications for substance use disorder and to recommend that others use them was significantly influenced by whether they believed that important people in their lives approved of using these medications. This finding is in line with what we already know concerning the impact of social influences, especially friends and family, on treatment and recovery outcomes. The findings of the present study suggest that increasing the use and acceptability of this type of treatment among participants within collegiate recovery programs depends on shaping the attitudes of and leveraging the support of their broader social networks.
In addition, this study found that students who perceived these medications as effective were more likely to accept and recommend them to others. This finding squares with what is known about the relationship between patient beliefs and treatment engagement. This relationship has been observed both in broader healthcare contexts and specifically in the treatment of substance use disorders.
One interesting caveat to this finding was the observation that there was no significant link between knowledge of these medications and intent to use them. In other words, believing in the effectiveness of the medications had more to do with whether they were accepted and recommended than knowledge of their effectiveness. Another caveat was the fact that the participants’ “drug of choice” had no significant effect on their use or encouragement to use medications for substance use disorder. This observation may relate to whether their “drug of choice” was a substance other than those for which these medications are typically used (alcohol and opioids). It may also be due to their length of time in recovery, reducing the perceived need for medications aimed at treating symptoms like craving. In any case, the finding that perceived effectiveness significantly impacted students’ use and endorsement of these medications suggests that improving perceptions of effectiveness could be a useful strategy for increasing their use and acceptability among students.
The study presents several limitations that are crucial to consider when interpreting the findings:
The research reveals that both the personal attitudes of students towards medications for substance use disorders and the perceived approval from important figures in their lives may explain their willingness to use these medications and to encourage their use among peers. Ultimately, while recognizing the study’s limitations, its findings point towards the potential for targeted interventions that could bridge the gap between medications for substance use disorders efficacy and its adoption in collegiate settings, underscoring the influence of informed attitudes and supportive networks.
Tuliao, A. P., Tuliao, M. D., Lewis, L. E., Mullet, N. D., North-Olague, J., Mills, D., Kimball, T., & Shumway, S. (2023). Perceptions of Addiction Medications Within Collegiate Recovery Communities. Journal of Addiction Medicine, 17(6), 732–735. doi: 10.1097/ADM.0000000000001224
l
There are several FDA-approved medications for substance use disorders, such as buprenorphine/naloxone and methadone for opioid use disorder, and naltrexone, acamprosate, and disulfiram for alcohol use disorder. Despite their utility, younger individuals tend to have more negative attitudes toward them and toward psychotropic medications more generally. With respect to opioid agonist medications, in particular, young adults may encounter negative views from peers, which could impact their willingness to take or continuing taking these medications.
Collegiate recovery communities are designed to help prevent relapse and enhance academic success for young adults with recovery from substance use disorder through specialized programming and robust peer and staff support. Given their growing presence across US universities, collegiate recovery students are important stakeholders in efforts to understand and address young adult attitudes toward substance use disorder medications. This is especially relevant given dynamic policy shifts to accommodate multiple pathways to recovery including efforts to help individuals taking agonist medications, longer-acting opioids associated with reduced opioid use and overdose risk.
Investigating the medication use and attitudes of collegiate recovery program affiliates holds promise to guide interventions to overcome barriers to accessing these collegiate resources, especially among young adults with substance use disorders. The findings may illuminate ways to boost medication adoption within these communities and for young people with substance use disorder more generally. This study examined substance use disorder medication attitudes across collegiate recovery programs from 43 US universities.
This was a cross-sectional study of 162 students in 43 collegiate recovery programs designed to understand why these students might consider taking, or encourage others to consider taking, medications to manage substance use disorders. Drawing on the Theory of Planned Behavior, which suggests that intentions guide actions and are shaped by attitudes, social norms, and perceived control, the study aimed to uncover the factors influencing students’ decisions.
Participants responded to several survey questions intended to assess their attitudes toward and acceptance of medications for substance use disorder. The study examined predictors of three variables related to substance use disorder medication intentions: 1) their own intention to use medication; 2) their perceived acceptability of medications; and 3) their willingness to encourage others to use medications. For each survey item, students provided a rating on a scale from 1 (unlikely or unacceptable) to 7 (likely or acceptable).
Specifically, controlling for variables including gender, mutual-help participation, drug of choice, current addiction medicine use, knowledge of addiction medicine, year in collegiate recovery program, analyses tested whether participants’ attitudes were associated with these intentions. Then also accounting for these attitudes, analyses tested whether social norms were associated with these intentions. To understand the influence of social norms, the survey asked students to rate how much they felt supported by significant others in their decision to take these medications and gauged the openness and attitudes of other students, as well as the collegiate recovery program staff towards these medications.
The median age of the sample participants was 25 years old (mean = 27), with participants ranging from 18 to 56 years old. The group was 56% male, and 35% were graduate students. Most participants identified as White (83%), with smaller representations of Bi-/Multiracial (9%), Asian American (3%), African American (2%), and Hispanic (1%). On average, students had been enrolled in a collegiate recovery program for 1.5 years and had undergone nearly 2 prior treatments for substance use disorder. Three-fourths had a history of substance use disorder treatment.
Students generally considered these medications moderately acceptable, with an average rating of 4.88 out of 7. Despite this moderate acceptability, the intent to use these medications was low, with an average rating of 1.88 out of 7. The willingness to encourage others to use these medications was also moderate, with an average rating of 3.18 out of 7.
Acceptance by important others predicts intent to use and to encourage use of substance use disorder medications
Examining students’ likelihood of using medications for substance use disorders showed that once perceived social norms were factored in, the direct influence of beliefs regarding medication effectiveness on intent to use faded, while acceptance by important others remained a strong predictor. Feeling that important others accept medications for substance use disorder explained 14% of intent to use these medications and 3% of encouragement to others to use them.
Positive attitudes toward substance use disorder medications predict acceptability and encouragement
After accounting for social influences, students’ positive attitudes towards medications for substance use disorders and their belief in their effectiveness consistently correlated with greater acceptance of their use. When individuals personally hold positive views towards medications for substance use disorders, it significantly impacts their acceptance of these treatments, and their tendency to promote them among others. Having a positive attitude towards medications for substance use disorder explains 49% of medication acceptability and 38% of encouragement to others to use them.
Perceived effectiveness of substance use disorder medications predicts acceptability and encouragement
Believing in the effectiveness of medications for substance use disorder explains 40% of medication acceptability and 33% encouragement to others to use them.
This study examined factors influencing students’ decisions to take and recommend to their peers medications for substance use disorders. The researchers examined these factors in light of three key dimensions that were adapted from the Theory of Planned Behavior, namely, the students’ attitudes toward these medications, their intentions to use them, and their willingness to recommend that others use them.
The study found that students with positive attitudes towards these medications were more likely to find these medications acceptable and to encourage their peers to take them. This finding makes sense in light of what we already know about the impact of negative attitudes and stigma as barriers to starting and maintaining medication treatment for opioid use disorder within different treatment contexts, such as healthcare settings and recovery community centers. Other research has shown that people may perceive negative message about these medications when attending mutual-help groups, such as Alcoholics Anonymous or Narcotics Anonymous; though such messages may come from a small, albeit influential, group of individuals. It was surprising, then, that in the present study there was no unique effect of participation in mutual-help groups on the intention to use these medications. It is possible that the specific measure used to evaluate their participation (a single question asking: “Have you ever considered yourself a member of a mutual-help group?”) was not nuanced enough to establish the unique influence of these groups on medication attitudes. What this finding adds to our broader understanding is the relevance of attitudes to the acceptability of these medications within the specific context of collegiate recovery programs. The implications are that increasing the use and acceptability of this type of treatment requires improving the medication-related attitudes among individuals within this population.
The study also found that students’ intent to use medications for substance use disorder and to recommend that others use them was significantly influenced by whether they believed that important people in their lives approved of using these medications. This finding is in line with what we already know concerning the impact of social influences, especially friends and family, on treatment and recovery outcomes. The findings of the present study suggest that increasing the use and acceptability of this type of treatment among participants within collegiate recovery programs depends on shaping the attitudes of and leveraging the support of their broader social networks.
In addition, this study found that students who perceived these medications as effective were more likely to accept and recommend them to others. This finding squares with what is known about the relationship between patient beliefs and treatment engagement. This relationship has been observed both in broader healthcare contexts and specifically in the treatment of substance use disorders.
One interesting caveat to this finding was the observation that there was no significant link between knowledge of these medications and intent to use them. In other words, believing in the effectiveness of the medications had more to do with whether they were accepted and recommended than knowledge of their effectiveness. Another caveat was the fact that the participants’ “drug of choice” had no significant effect on their use or encouragement to use medications for substance use disorder. This observation may relate to whether their “drug of choice” was a substance other than those for which these medications are typically used (alcohol and opioids). It may also be due to their length of time in recovery, reducing the perceived need for medications aimed at treating symptoms like craving. In any case, the finding that perceived effectiveness significantly impacted students’ use and endorsement of these medications suggests that improving perceptions of effectiveness could be a useful strategy for increasing their use and acceptability among students.
The study presents several limitations that are crucial to consider when interpreting the findings:
The research reveals that both the personal attitudes of students towards medications for substance use disorders and the perceived approval from important figures in their lives may explain their willingness to use these medications and to encourage their use among peers. Ultimately, while recognizing the study’s limitations, its findings point towards the potential for targeted interventions that could bridge the gap between medications for substance use disorders efficacy and its adoption in collegiate settings, underscoring the influence of informed attitudes and supportive networks.
Tuliao, A. P., Tuliao, M. D., Lewis, L. E., Mullet, N. D., North-Olague, J., Mills, D., Kimball, T., & Shumway, S. (2023). Perceptions of Addiction Medications Within Collegiate Recovery Communities. Journal of Addiction Medicine, 17(6), 732–735. doi: 10.1097/ADM.0000000000001224
l
There are several FDA-approved medications for substance use disorders, such as buprenorphine/naloxone and methadone for opioid use disorder, and naltrexone, acamprosate, and disulfiram for alcohol use disorder. Despite their utility, younger individuals tend to have more negative attitudes toward them and toward psychotropic medications more generally. With respect to opioid agonist medications, in particular, young adults may encounter negative views from peers, which could impact their willingness to take or continuing taking these medications.
Collegiate recovery communities are designed to help prevent relapse and enhance academic success for young adults with recovery from substance use disorder through specialized programming and robust peer and staff support. Given their growing presence across US universities, collegiate recovery students are important stakeholders in efforts to understand and address young adult attitudes toward substance use disorder medications. This is especially relevant given dynamic policy shifts to accommodate multiple pathways to recovery including efforts to help individuals taking agonist medications, longer-acting opioids associated with reduced opioid use and overdose risk.
Investigating the medication use and attitudes of collegiate recovery program affiliates holds promise to guide interventions to overcome barriers to accessing these collegiate resources, especially among young adults with substance use disorders. The findings may illuminate ways to boost medication adoption within these communities and for young people with substance use disorder more generally. This study examined substance use disorder medication attitudes across collegiate recovery programs from 43 US universities.
This was a cross-sectional study of 162 students in 43 collegiate recovery programs designed to understand why these students might consider taking, or encourage others to consider taking, medications to manage substance use disorders. Drawing on the Theory of Planned Behavior, which suggests that intentions guide actions and are shaped by attitudes, social norms, and perceived control, the study aimed to uncover the factors influencing students’ decisions.
Participants responded to several survey questions intended to assess their attitudes toward and acceptance of medications for substance use disorder. The study examined predictors of three variables related to substance use disorder medication intentions: 1) their own intention to use medication; 2) their perceived acceptability of medications; and 3) their willingness to encourage others to use medications. For each survey item, students provided a rating on a scale from 1 (unlikely or unacceptable) to 7 (likely or acceptable).
Specifically, controlling for variables including gender, mutual-help participation, drug of choice, current addiction medicine use, knowledge of addiction medicine, year in collegiate recovery program, analyses tested whether participants’ attitudes were associated with these intentions. Then also accounting for these attitudes, analyses tested whether social norms were associated with these intentions. To understand the influence of social norms, the survey asked students to rate how much they felt supported by significant others in their decision to take these medications and gauged the openness and attitudes of other students, as well as the collegiate recovery program staff towards these medications.
The median age of the sample participants was 25 years old (mean = 27), with participants ranging from 18 to 56 years old. The group was 56% male, and 35% were graduate students. Most participants identified as White (83%), with smaller representations of Bi-/Multiracial (9%), Asian American (3%), African American (2%), and Hispanic (1%). On average, students had been enrolled in a collegiate recovery program for 1.5 years and had undergone nearly 2 prior treatments for substance use disorder. Three-fourths had a history of substance use disorder treatment.
Students generally considered these medications moderately acceptable, with an average rating of 4.88 out of 7. Despite this moderate acceptability, the intent to use these medications was low, with an average rating of 1.88 out of 7. The willingness to encourage others to use these medications was also moderate, with an average rating of 3.18 out of 7.
Acceptance by important others predicts intent to use and to encourage use of substance use disorder medications
Examining students’ likelihood of using medications for substance use disorders showed that once perceived social norms were factored in, the direct influence of beliefs regarding medication effectiveness on intent to use faded, while acceptance by important others remained a strong predictor. Feeling that important others accept medications for substance use disorder explained 14% of intent to use these medications and 3% of encouragement to others to use them.
Positive attitudes toward substance use disorder medications predict acceptability and encouragement
After accounting for social influences, students’ positive attitudes towards medications for substance use disorders and their belief in their effectiveness consistently correlated with greater acceptance of their use. When individuals personally hold positive views towards medications for substance use disorders, it significantly impacts their acceptance of these treatments, and their tendency to promote them among others. Having a positive attitude towards medications for substance use disorder explains 49% of medication acceptability and 38% of encouragement to others to use them.
Perceived effectiveness of substance use disorder medications predicts acceptability and encouragement
Believing in the effectiveness of medications for substance use disorder explains 40% of medication acceptability and 33% encouragement to others to use them.
This study examined factors influencing students’ decisions to take and recommend to their peers medications for substance use disorders. The researchers examined these factors in light of three key dimensions that were adapted from the Theory of Planned Behavior, namely, the students’ attitudes toward these medications, their intentions to use them, and their willingness to recommend that others use them.
The study found that students with positive attitudes towards these medications were more likely to find these medications acceptable and to encourage their peers to take them. This finding makes sense in light of what we already know about the impact of negative attitudes and stigma as barriers to starting and maintaining medication treatment for opioid use disorder within different treatment contexts, such as healthcare settings and recovery community centers. Other research has shown that people may perceive negative message about these medications when attending mutual-help groups, such as Alcoholics Anonymous or Narcotics Anonymous; though such messages may come from a small, albeit influential, group of individuals. It was surprising, then, that in the present study there was no unique effect of participation in mutual-help groups on the intention to use these medications. It is possible that the specific measure used to evaluate their participation (a single question asking: “Have you ever considered yourself a member of a mutual-help group?”) was not nuanced enough to establish the unique influence of these groups on medication attitudes. What this finding adds to our broader understanding is the relevance of attitudes to the acceptability of these medications within the specific context of collegiate recovery programs. The implications are that increasing the use and acceptability of this type of treatment requires improving the medication-related attitudes among individuals within this population.
The study also found that students’ intent to use medications for substance use disorder and to recommend that others use them was significantly influenced by whether they believed that important people in their lives approved of using these medications. This finding is in line with what we already know concerning the impact of social influences, especially friends and family, on treatment and recovery outcomes. The findings of the present study suggest that increasing the use and acceptability of this type of treatment among participants within collegiate recovery programs depends on shaping the attitudes of and leveraging the support of their broader social networks.
In addition, this study found that students who perceived these medications as effective were more likely to accept and recommend them to others. This finding squares with what is known about the relationship between patient beliefs and treatment engagement. This relationship has been observed both in broader healthcare contexts and specifically in the treatment of substance use disorders.
One interesting caveat to this finding was the observation that there was no significant link between knowledge of these medications and intent to use them. In other words, believing in the effectiveness of the medications had more to do with whether they were accepted and recommended than knowledge of their effectiveness. Another caveat was the fact that the participants’ “drug of choice” had no significant effect on their use or encouragement to use medications for substance use disorder. This observation may relate to whether their “drug of choice” was a substance other than those for which these medications are typically used (alcohol and opioids). It may also be due to their length of time in recovery, reducing the perceived need for medications aimed at treating symptoms like craving. In any case, the finding that perceived effectiveness significantly impacted students’ use and endorsement of these medications suggests that improving perceptions of effectiveness could be a useful strategy for increasing their use and acceptability among students.
The study presents several limitations that are crucial to consider when interpreting the findings:
The research reveals that both the personal attitudes of students towards medications for substance use disorders and the perceived approval from important figures in their lives may explain their willingness to use these medications and to encourage their use among peers. Ultimately, while recognizing the study’s limitations, its findings point towards the potential for targeted interventions that could bridge the gap between medications for substance use disorders efficacy and its adoption in collegiate settings, underscoring the influence of informed attitudes and supportive networks.
Tuliao, A. P., Tuliao, M. D., Lewis, L. E., Mullet, N. D., North-Olague, J., Mills, D., Kimball, T., & Shumway, S. (2023). Perceptions of Addiction Medications Within Collegiate Recovery Communities. Journal of Addiction Medicine, 17(6), 732–735. doi: 10.1097/ADM.0000000000001224
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