Perspectives on medication for opioid use disorder (MOUD) access and service delivery among a community sample of people who use opioids in Los Angeles

Abstract

Introduction

Medications for opioid use disorder (MOUD) such as buprenorphine and methadone are effective in reducing overdoses, drug use, and drug-related harms. Despite the benefits, MOUD is under-utilized among people who use opioids (PWUO) and this access and service delivery gap is more pronounced among community recruited PWUO who experience greater barriers to treatment entry. Limited qualitative studies have explored MOUD service and delivery barriers among this population. To address this gap, our study investigates the MOUD experiences, preferences, perceived benefits, and unmet treatment needs of a community sample of PWUO in Los Angeles.

Methods

Between September 2021–April 2022, qualitative interviews were conducted with PWUO in Los Angeles, California (N = 22) recruited from two community sites. Participants were at least 18 years old and self-reported opioid and injection drug use in the last 30 days. Participants answered questions related to general experiences with MOUD. We followed a thematic analysis approach to identify common themes that emerged from qualitative interview data.

Results

Nearly a third of the sample was male (64 %), Hispanic/Latino (64 %), and the majority (73 %) reported an income of less than $1400 in the prior month. Participants reported: 1) hesitance initiating methadone treatment due to stigma 2) initiating MOUD to manage withdrawal and meet self-determined goals 3) comparing buprenorphine and methadone for withdrawal management to determine future treatment plans 4) being able to reduce interactions with the risk environment due to MOUD treatment and 5) recommending expanded MOUD access and improving delivery.

Conclusions

Our findings support expanded and low to no barrier access and delivery of MOUD for socially disadvantaged PWUO who receive treatment in community settings.