Education Intervention Boosts Psychiatrists’ Knowledge and Attitudes on mOUD

Despite strong evidence that medications for opioid use disorder (mOUD) are effective treatments, they remain underutilized in clinical psychiatric practice.

Ahead of her presentation at the 2026 New York Society of Addiction Medicine (NYSAM) Annual Meeting, Psych Congress Network spoke with Evguenia Makovkina, MD, about her session “Exploring Psychiatrists’ Knowledge, Attitudes, and Practices in Treating Opioid Use Disorder: A Pilot Study with an Online Educational Module.” In this interview, Dr Makovkina discusses key findings from her pilot study examining psychiatrists’ baseline knowledge, attitudes, and prescribing practices related to medications for opioid use disorder (mOUD), as well as the impact of a brief online educational intervention across career stages.

Key Clinical Summary

• In a pilot study of psychiatrists practicing in inpatient and emergency psychiatry settings, 72% had not prescribed buprenorphine in the past 12 months, 43% felt confident discussing medications for opioid use disorder (OUD), 47% reported dissatisfaction working with patients with OUD, and baseline knowledge scores averaged ~50%, with no differences by career stage.
• Immediately after completing a brief online educational module on managing OUD, participants demonstrated significant improvements in knowledge, attitudes, and practice survey scores across experience levels.
• Non-early-career psychiatrists showed significantly greater post-intervention score increases than early-career psychiatrists, supporting inclusion of experienced clinicians in addiction-focused education

Psych Congress Network (PCN): What led you to investigate psychiatrists’ knowledge, attitudes, and clinical practices around opioid use disorder (OUD)?

Evguenia Makovkina, MD: During psychiatry residency, I came across data that showed we were underprescribing medications for opioid use disorder (mOUD) relative to the number of patients with OUD we were treating in the inpatient psychiatry and emergency psychiatry settings. I also noticed that while many psychiatry trainees and early career psychiatrists were enthusiastic about initiating mOUD for hospitalized patients, there was hesitancy and discomfort with prescribing mOUD among more experienced psychiatrists. My co-resident, Dr Nia Harris, and I noticed that this dynamic may have resulted from a knowledge gap and was getting in the way of providing gold standard care to patients with OUD— this is what led us to investigate knowledge, attitudes, and practices around OUD among psychiatrists and to create an educational module for managing OUD. We were particularly curious about whether there were differences in knowledge, attitudes, and clinical practices among early-career psychiatrists (trainees and attendings with fewer than 5 years of practice) and non-early-career psychiatrists (attendings with 5 or more years of practice) given our anecdotal experience during training.

PCN: Before the educational intervention, what did you find about psychiatrists’ understanding of OUD treatment? How might these attitudes affect patient access to evidence-based care?

Dr Makovkina: We found that most psychiatrists—approximately 72%—who participated in our study had never prescribed buprenorphine, a gold-standard treatment for OUD, in the past 12 months. Less than half of the psychiatrists in our study—approximately 43%—felt confident discussing medications for treating OUD with patients, and nearly half (47%) did not find it satisfying to work with patients diagnosed with OUD. This is concerning because negative attitudes can get in the way of self-directed learning and providing gold-standard care to patients with OUD. On average, participants scored about 50% on the knowledge portion of our survey before completing the educational module. We found no significant differences in knowledge, attitudes, or practice scores between early-career and non-early-career psychiatrists at baseline.

PCN: Following completion of the module, what changes did you observe in clinician knowledge, attitudes, or intended clinical behaviors?

Dr Makovkina: We found that knowledge, attitude, and practice survey scores significantly increased across all participants regardless of experience level. Interestingly, we found significantly greater score increases in non-early-career psychiatrists compared to early-career psychiatrists. It is difficult to draw conclusions about how clinical behaviors changed after the intervention given that we administered the post-intervention survey immediately after the educational module. However, we would hope that through the significant improvement in both knowledge and attitudes participants would feel more inclined to prescribe mOUD themselves, or at least recognize OUD in patients and refer them to the appropriate providers.

PCN: Given the high prevalence of co-occurring psychiatric conditions in patients with OUD, how does improving psychiatrists’ competency in OUD treatment impact broader mental health outcomes?

Dr Makovkina: Prior studies have shown that comorbid OUD can lead to worse mental health outcomes, so it’s incredibly important for psychiatrists to be able to recognize and diagnose OUD given its high co-occurrence rate with other psychiatric disorders. Both conditions influence each other bidirectionally, so it’s important to treat both OUD and the psychiatric condition simultaneously instead of sequentially. We hope that improving psychiatrists’ competency in OUD treatment will help them shift their patients toward mental health recovery more effectively.

PCN: How do you plan to build on this pilot study in future research?

Dr Makovkina: We would like to distribute this educational module to other departments within our hospital system and re-administer the survey to the psychiatrists who already completed this study to see if the shifts in knowledge and attitudes are maintained over time after one brief intervention. We would also like to collect qualitative feedback as part of the follow-up and evaluate whether the module had any impact on prescribing or practice patterns.

PCN: What is the most significant takeaway from your findings that you’d like to emphasize for our audience of practicing clinicians?

Dr Makovkina: It is feasible and important to include more experienced clinicians—not only trainees—in educational interventions focused on addiction treatment in order to shift attitudes and knowledge in a practice setting, particularly when a treatment team consists of clinicians at different stages of experience.

Evguenia Makovkina, MD, is a diplomate of the American Board of Psychiatry and Neurology in adult psychiatry. She completed residency training in adult psychiatry and fellowship training in addiction psychiatry at New York Presbyterian Hospital - Weill Cornell Medical Center. She is currently an Assistant Professor of Clinical Psychiatry at Weill Cornell Medicine and an Assistant Attending Psychiatrist at NewYork-Presbyterian Hospital, where she supervises trainees and co-directs the Support, Advocacy and Family Education (SAFE) Program within the Weill Cornell Medicine Program for Substance Use and Stigma of Addiction. Her clinical and research interests center on developing and implementing integrated care models that reduce healthcare fragmentation and stigma for individuals with substance use disorders, with a particular focus on those with co-occurring psychiatric conditions during emerging adulthood and the perinatal period.

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