Stigma and knowledge about medications for alcohol use disorder among treatment-seeking adults

Despite demonstrated effectiveness, medications for alcohol use disorder (MAUD) are underutilized. While studies have considered structural and provider-level barriers, little is known about patient-level factors associated with MAUD initiation. We aimed to examine stigma, knowledge, and beliefs about MAUD and their associations with intention to take them among a sample with severe AUD.

Adults receiving treatment for alcohol use disorder at an inpatient withdrawal management and treatment initiation program completed a cross-sectional survey (N = 171). MAUD knowledge (i.e., correctly identified medications for AUD), beliefs (i.e., perceived effectiveness), and stigma (i.e., internalized and perceived) in general and by medication type (i.e., naltrexone, acamprosate, and disulfiram) were assessed using a measure developed for this study.

Knowledge about which medications are indicated for AUD was low, with the highest awareness for naltrexone (61 % of participants correctly identified this medication). Most (55 %) participants believed MAUD helps people recover, however approximately half were uncertain about the effectiveness of each specific medication type. Participants with greater MAUD knowledge and more positive beliefs about effectiveness reported greater intention to take MAUD (ps < 0.05). Stigma was low across all medications (mean scores <3 on a scale of 10), though a substantial portion of participants endorsed uncertainty about stigma.

Greater knowledge and positive beliefs about MAUD were significantly associated with intentions to pursue MAUD, yet many participants reported uncertainty in these domains. MAUD knowledge was low overall, as was stigma. Targeted efforts to enhance patient knowledge of MAUD could be a promising strategy for increasing medication uptake.