Acceptability of nonabstinent treatment outcome goals among addiction treatment providers in Ukraine

Abstract

We examined whether acceptability of nonabstinence treatment outcome goals varied as a function of a patient's severity of diagnosis (ICD-10 harmful use vs. dependence syndrome; World Health Organization, 1992), finality of outcome goal (intermediate vs. final), and type of substance (e.g., tobacco, alcohol, cannabis), among addiction treatment providers in Ukraine. We surveyed 44% of Ukrainian treatment providers (n = 446/1023; Mage = 40.4, SD = 8.6; Male = 67%; MYears Of Experience = 10.2, SD = 7.2). For tobacco use, most respondents (78%-93%) rated nonabstinence as acceptable, regardless of diagnostic severity or finality of outcome goal (i.e., intermediate, final). Most respondents also rated nonabstinence as acceptable as an intermediate or final goal for patients with harmful use of alcohol (70% to 86%) or cannabis (71% to 93%); however, nonabstinence was less commonly indicated by respondents as an intermediate goal for patients with a dependence syndrome (alcohol = 52%; cannabis = 68%). Regarding other drug use, although most rated nonabstinence acceptable as an intermediate goal for patients with harmful use of opioids (68%) or sedatives (64%), fewer rated nonabstinence acceptable as a final goal (26% to 33%), particularly for patients with a dependence syndrome (10% to 27%). Very few providers (5% to 15%) rated nonabstinence acceptable for other substances. Patients in Ukraine who wish to moderate cannabis or tobacco use will find that their provider is typically accepting of this goal; however, providers are mixed regarding whether alcohol and opioid moderation is appropriate, particularly for those with dependence. Findings support education and research efforts to better understand how provider and patient alignment regarding goals impact patient outcomes following substance use treatment in Ukraine. (PsycINFO Database Record