Counselor attitudes toward pharmacotherapies for alcohol dependence.

OBJECTIVE Addiction treatment counselors play a central role in the dissemination of information about new treatment techniques to alcohol-dependent patients and are key in the implementation of new treatment technologies. Building on previous research, this study examines counselors' perceptions of the effectiveness and acceptability of pharmacotherapies for the treatment of alcohol dependence. METHOD Mail questionnaires were received from 1,140 counselors employed in a nationally representative sample of public-sector addiction treatment programs in 2006. Counselors answered a series of questions about three U.S. Food and Drug Administration (FDA)-approved medications used in the treatment of alcohol dependence (disulfiram [Antabuse], tablet naltrexone [Revia], and acamprosate [Campral]), indicating their extent of familiarity with the medication, its perceived effectiveness in the treatment of alcohol dependence, and its acceptability for use with alcohol-dependent patients. RESULTS The extent of diffusion of these pharmacotherapies was associated with time since FDA approval. Counselors reported receiving little or no pharmacotherapy-specific training. Multivariate models showed that the receipt of medication-specific training as well as indirect observation of the medication's use in the treatment program were significantly associated with diffusion of information about these pharmacotherapies and counselors' perceptions of the effectiveness and acceptability of the medications for use in addiction treatment. CONCLUSIONS When exposed to information about medications to treat alcohol dependence, counseling staff appear quite receptive. More efforts are needed to disseminate information about alcohol pharmacotherapies to front-line addiction treatment staff.