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.