Short CommunicationHeroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification

- Lower perceived refusal self-efficacy was associated with a greater likelihood of expressing preference for MAT (versus no MAT).
- Depressed mood was associated with a greater likelihood of expressing preference for MAT (versus no MAT).
- Persons preferring MAT did not differ from those wanting MAT with respect to demographics, IDU, and prior detox or MAT.

ObjectiveAn individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification.MethodParticipants (N = 397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT.ResultsControlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT).ConclusionsPerceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery.