"If You Plant That Seed, It Will Grow": A Qualitative Study to Improve Linkage to Care among Patients with Methamphetamine Use Disorder in Emergency Department Settings.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Deborah J Rinehart, Karina G Duarte, Aiden Gilbert, Alia Al-Tayyib, Katherine Camfield, Scott A Simpson
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Abstract

Objectives: Methamphetamine addiction is a serious and difficult-to-treat disorder. Existing treatment options are limited, and patient perspectives on effective strategies are lacking. Emergency departments (EDs) may be a critical entry point for individuals with methamphetamine use disorder (MUD) to be identified and linked to treatment. We aimed to understand patients' perspectives regarding their methamphetamine use and related ED experiences and how to improve linkage to substance treatment.

Methods: Between July and November 2022, semistructured qualitative interviews were conducted with adult patients with MUD in an urban safety-net healthcare setting in Denver, Colorado. Interviews were recorded, summarized, and analyzed using the Rapid Assessment Process.

Results: During the interviews, 18 patients shared their experiences. Participants described feeling stigmatized and experiencing a lack of communication from ED staff during their visit. Additionally, participants shared the perception that ED staff often did not take their health concerns seriously once substance use was identified. Participants were uncertain about overdose risk and felt that their psychiatric symptoms complicated treatment. Referrals to treatment were lacking, and participants supported a care navigation intervention that incorporates elements of contingency management. Participants also shared the importance of ED staff recognizing their social needs and being empathetic, trauma-informed, and flexible to meet patients where they are regardless of their readiness to seek treatment.

Conclusions: Treatment options and entry points for individuals with MUD are currently limited. The patient perspectives described here are helpful in developing services to support, engage, and link individuals to MUD services after discharge from ED services.

"如果你种下那颗种子,它就会长大":一项定性研究,旨在改善急诊科甲基苯丙胺使用障碍患者的护理联系。
目标:甲基苯丙胺成瘾是一种严重且难以治疗的疾病。现有的治疗方案很有限,而且缺乏患者对有效策略的看法。急诊科(ED)可能是识别甲基苯丙胺使用障碍(MUD)患者并将其与治疗联系起来的关键切入点。我们旨在了解患者对其甲基苯丙胺使用和相关急诊室经历的看法,以及如何改善与药物治疗的联系:2022 年 7 月至 11 月期间,我们在科罗拉多州丹佛市的一个城市安全网医疗机构中对患有 MUD 的成年患者进行了半结构化定性访谈。采用快速评估流程对访谈进行记录、总结和分析:在访谈过程中,18 名患者分享了他们的经历。参与者描述了他们在就诊期间感到被污名化以及急诊室工作人员缺乏沟通的经历。此外,参与者还认为,一旦发现使用药物,急诊室工作人员往往不会认真对待他们的健康问题。参与者对用药过量的风险不确定,并认为他们的精神症状使治疗变得复杂。缺乏治疗转介,参与者支持结合应急管理元素的护理导航干预。参与者还认为,急诊室工作人员必须认识到患者的社会需求,并以同理心、创伤意识和灵活性来满足患者的需求,无论他们是否准备寻求治疗:目前,针对 MUD 患者的治疗方案和切入点非常有限。本文所描述的患者观点有助于开发相关服务,以支持、吸引患者并在他们从急诊室出院后将其与 MUD 服务联系起来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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