Attitudes and beliefs of doctors prescribing methadone to addicts in the Westfalen-Lippe region of Germany

Doctors who prescribe methadone to heroin addicts in the Westfalen-Lippe region of Germany were surveyed in 1996 to develop and use German versions of existing Australian and American scales. Two scales were developed from 247 responses using confirmatory factor analysis and Cronbach's alpha. The 10-item abstinence orientation (AO) scale measures strength of commitment to abstinence-orientated treatment policies, and the five-item disapproval of drug use (DDU) scale measures disapproval of illicit drug use. Half the respondents supported and a quarter strongly supported abstinence-orientated policies, while a quarter supported a punitive societal response to illicit drug use. Scores on the two scales were highly and positively correlated; the stronger the support for abstinence-orientated policies, the greater the disapproval of illicit drug use. The doctors' median score on a test of knowledge of the risks and benefits of methadone maintenance was six of a possible 10. While allowing for DDU scores, support for abstinence-orientated policies was stronger among the less well-informed doctors. The attitudes and beliefs and lack of knowledge identified in the survey are a cause for concern. Previous work has shown there were similar problems among methadone prescribers and staff of methadone units in Sydney, Australia and New York City, USA.