The adoption of tablet naltrexone in the private substance abuse treatment sector
O'Brien, Lauren Alyce
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The result of the parallel but disparate development of the SUD treatment field and SUD research field has been the development of a gap between research and practice. A salient consequence of this research to practice gap is the lack of addiction pharmacotherapy adoption among SUD treatment providers. One effective pharmacotherapy with a suboptimal adoption rate is tablet naltrexone. My study is the first to directly test the organizational-level hypotheses of Neo-institutional Theory to determine what institutional pressures are successful in influencing private SUD treatment centers to adopt tablet naltrexone using a longitudinal design. Using generalized estimating equations (GEE), I obtained the odds of tablet naltrexone adoption over time in a panel of (244) private SUD treatment centers as a function of three isomorphic pressures: coercive, mimetic, and normative. My findings reveal strong support for the influence of coercive pressures on adoption, partial support for normative pressures, and no support for the influence of mimetic pressures on adoption behaviors. The implications of my study findings are discussed along with suggestions for future research.