Jordan Stipek, Jennifer J Mootz, Frank L Johnson, Kevin A Hallgren, Atasha L Brown, Alexandra Perron, Clinton Alexander, Brenna L Greenfield
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引用次数: 0
Abstract
Introduction: American Indian and Alaska Native individuals are disproportionately impacted by the opioid epidemic, partially due to structural racism. Tribal nations and communities are finding innovative ways to provide opioid use disorder (OUD) treatment, but barriers to medications for opioid use disorder (MOUD) remain. This study surveyed Indigenous clients at a Syringe Services Program about barriers and facilitators to OUD treatment.
Methods: Interviews were conducted with 27 Indigenous individuals who had used opioids in the past month and were receiving opioid harm reduction services from a tribally-run Anishinaabe Syringe Services Program (rural Minnesota). Participants were asked five questions in interview style format about their experiences with opioid use disorder care with a focus on barriers and facilitators. The coding team analyzed interviews utilizing the Collaborative Story Analysis method to highlight overall impressions of participants' narratives.
Results: There were 27 participants: 48% male and 52% female. The main themes of barriers and facilitators were connection to others, flexibility of treatment services, and ensuring individual needs were met. Having a positive relationship with providers (e.g. non-judgmental), access to MOUD and Harm Reduction services, and minimizing assessment requirements prior to starting treatment were some of the most frequently identified facilitators to care. Lack of transportation, prioritizing care for others, and turbulent relationships with providers and certain aspects of care services were identified as barriers.
Conclusions: Study participants cited clear barriers and facilitators to accessing OUD treatment in a rural Anishinaabe Tribal Nation in Minnesota. The Tribal Nation has already implemented several strategies to improve access to MOUD care (e.g., hiring additional drivers to help with transportation, facilitating immediate MOUD care prior to an intake, if needed, and giving take home MOUD doses). Tailoring services to address identified barriers and leverage facilitators of connection and flexibility will enhance care.
期刊介绍：
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use.
Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations.
Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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