Characteristics associated with forced treatment discontinuation among people who use drugs in Rhode Island

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-04-19 DOI:10.1016/j.drugalcdep.2025.112686

Evelyn Lai , Katie B. Biello , Jane A. Buxton , Brandon D.L. Marshall , Alexandria Macmadu

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引用次数: 0

Abstract

Background

A barrier to remaining in substance use treatment in the U.S. is abstinence-based policies, which can lead to premature treatment termination. In this study, we examine factors associated with forced treatment discontinuation due to substance use among participants in the Rhode Island Prescription and Illicit Drug Study (RAPIDS).

Methods

We examined baseline data from RAPIDS participants (who enrolled between August 2020 and February 2023) and who reported any history of enrollment in substance use treatment programs. Modified Poisson regression was used to assess sociodemographic, drug use behavior, and clinical characteristics associated with forced treatment discontinuation due to substance use. The type of treatment from which participants were removed and the drug(s) that were implicated in the removal were also summarized.

Results

Among 406 eligible participants, 96 (24 %) experienced forced treatment discontinuation due to drug or alcohol use. The most frequently reported program from which participants were removed was residential treatment (75 %). The most frequently reported drug that was implicated in the removal was crack cocaine (33 %). In the modified Poisson analysis, regular use of powder cocaine was associated with experiencing forced treatment discontinuation (adjusted prevalence ratio = 1.50; 95 % confidence interval: 1.05, 2.15).

Conclusions

Forced treatment discontinuation due to substance use is common, particularly in residential drug treatment. Our findings suggest a need for enhanced access to evidence-based treatments for stimulant use disorders. Persisting racial/ethnic disparities in treatment access underscores the need for strategies to ensure racial and ethnic equity in substance use treatment access and retention in care.

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罗德岛州吸毒者中强制停止治疗的相关特征

在美国，继续进行药物使用治疗的一个障碍是基于戒断的政策，这可能导致过早终止治疗。在这项研究中，我们研究了罗德岛处方和非法药物研究（RAPIDS）参与者中因药物使用而被迫停止治疗的相关因素。方法：我们检查了RAPIDS参与者的基线数据（他们在2020年8月至2023年2月期间入组），并报告了任何药物使用治疗计划的入组史。修正泊松回归用于评估社会人口学、药物使用行为和与药物使用导致的强制停药相关的临床特征。还总结了参与者被移除的治疗类型和涉及移除的药物。结果在406名符合条件的参与者中，96名（24%）因药物或酒精使用而被迫停止治疗。最常报道的参与者退出的项目是住院治疗（75%）。最常被报道的毒品是快克可卡因（33%）。在修正泊松分析中，经常使用粉状可卡因与被迫停止治疗相关(调整患病率= 1.50；95%置信区间：1.05,2.15)。结论因药物使用而强制停药现象普遍，特别是在住院药物治疗中。我们的研究结果表明，有必要加强对兴奋剂使用障碍的循证治疗。在获得治疗方面持续存在的种族/族裔差异突出表明，需要制定战略，确保在药物使用治疗的获得和护理中保持种族和族裔平等。

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

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.