Journal of Substance Abuse Treatment最新文献

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Improving geographic access to methadone clinics 改善美沙酮诊所的地理可及性
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108836
Anthony Bonifonte , Erin Garcia
{"title":"Improving geographic access to methadone clinics","authors":"Anthony Bonifonte ,&nbsp;Erin Garcia","doi":"10.1016/j.jsat.2022.108836","DOIUrl":"10.1016/j.jsat.2022.108836","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Opioid misuse is a nationwide public health crisis. </span>Methadone treatment<span> is proven to be highly successful in preventing opioid use disorder, reducing the use of illicit drugs<span>, and preventing overdoses. Clients acquire methadone daily from clinics, making geographic access crucial for the initiation of and adherence to treatment.</span></span></p></div><div><h3>Methods</h3><p><span>This work estimates unsatisfied methadone demand due to lack of geographic access at a census tract level and models the problem of identifying optimal locations to open new methadone clinics. The objective function of the model is a weighted combination of providing access to individuals with unmet methadone demand and improving the travel time of individuals currently attending a clinic. Data on existing methadone clinics and statewide methadone demand is acquired from Substance Abuse and Mental Health Services Administration (SAMHSA) surveys from 2019. Unsatisfied demand is estimated through a </span>linear regression model after aggregating the population, heroin use, and satisfied methadone demand at the state level.</p></div><div><h3>Results</h3><p>Nationwide, we find 18.2 % of the United States population does not have geographic access to a methadone clinic and estimate 77,973 individuals in these areas would attend a clinic if geographic access barriers were removed (95 % CI: 67,413–88,532). In a case study of six Midwestern states, we find that geography significantly contributes to the value of opening additional clinics and we see large differences in expected gains between states sharing similar characteristics such as population and satisfied methadone demand. The number of additional clients served by opening one new clinic ranges from 180 to 804 across these six states, representing between 8.4 % and 16.2 % of state unmet demand. Between 1.2 % and 14.1 % of existing clients were reassigned with a single newly opened clinic, with a one-way average travel distance improvement between 6.3 and 11.9 miles / person / day for these clients.</p></div><div><h3>Conclusions</h3><p>The results demonstrate the large unserved methadone demand in the United States, the significant improvement in methadone access for new and existing clients that can be achieved by opening new clinics, and the important role state-specific geography plays in these decisions.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108836"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40628482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Research to law: A qualitative study of Massachusetts' 2018 Care Act expanding emergency department initiation of medication for opioid use disorder 法律研究:对马萨诸塞州2018年《护理法》的定性研究,该法案扩大了急诊科对阿片类药物使用障碍药物的使用。
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108803
Rachel H. Alinsky , Catherine Silva , Hoover Adger , Emma E. McGinty
{"title":"Research to law: A qualitative study of Massachusetts' 2018 Care Act expanding emergency department initiation of medication for opioid use disorder","authors":"Rachel H. Alinsky ,&nbsp;Catherine Silva ,&nbsp;Hoover Adger ,&nbsp;Emma E. McGinty","doi":"10.1016/j.jsat.2022.108803","DOIUrl":"10.1016/j.jsat.2022.108803","url":null,"abstract":"<div><h3>Background</h3><p>Initiating medication for opioid use disorder (MOUD) during emergency department<span> (ED) visits is an important innovation to engage individuals in addiction treatment. In 2018, Massachusetts passed the CARE Act, becoming the first state to legislate that hospitals with EDs must be able to offer MOUD. We performed a qualitative study to explore factors influencing policy enactment.</span></p></div><div><h3>Methods</h3><p>Semi-structured interviews were conducted in 2019 with ten key stakeholders involved in the policymaking process representing state government, hospitals, physician professional societies, and recovery/behavioral health organizations. Data were analyzed in 2020–2021 using a hybrid inductive-deductive approach.</p></div><div><h3>Results</h3><p>The first key theme stakeholders expressed was the importance of research and public health consensus; they described consensus building within existing coalitions regarding the pressing need for action, and supporting expansion of treatment with this evidence-based strategy. Second, stakeholders discussed overcoming financing and feasibility concerns by passing budget-neutral legislation and ensuring flexibility for diverse hospital types. Lastly, stakeholders looked towards implementation, describing the implementation guide development process and ensuring capacity for continuing treatment existed throughout the state.</p></div><div><h3>Conclusions</h3><p>This study suggests that research supporting the effectiveness of ED MOUD induction drove the passage of this state legislation. Long-term collaboration between diverse stakeholders towards a common goal of increasing access to evidence-based treatment to address the opioid epidemic was also perceived as facilitating the law's passage. Policymakers and advocates in other states may look towards Massachusetts's legislative process as a model for implementing similar legislation as part of their strategies to address the drug overdose crisis.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108803"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49249424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with clinician treatment recommendations for patients with a new diagnosis of opioid use disorder 与临床医生对阿片类药物使用障碍新诊断患者的治疗建议相关的因素
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108827
Lewei (Allison) Lin , Victoria D. Powell , Colin Macleod , Amy S.B. Bohnert , Pooja Lagisetty
{"title":"Factors associated with clinician treatment recommendations for patients with a new diagnosis of opioid use disorder","authors":"Lewei (Allison) Lin ,&nbsp;Victoria D. Powell ,&nbsp;Colin Macleod ,&nbsp;Amy S.B. Bohnert ,&nbsp;Pooja Lagisetty","doi":"10.1016/j.jsat.2022.108827","DOIUrl":"10.1016/j.jsat.2022.108827","url":null,"abstract":"<div><h3>Background</h3><p>This study examined factors associated with treatment recommendations for patients with a new diagnosis of opioid use disorder (OUD), comparing recommendations for patients with clear signs of OUD versus those with lower likelihood of OUD.</p></div><div><h3>Methods</h3><p><span>The study conducted a retrospective medical chart review in a randomly selected national sample of 520 Veteran Health Administration patients with a new opioid-related electronic health record (EHR) diagnosis from 2012 to 2017. The study categorized patients as having “high likelihood” or “lower likelihood of OUD” based on the presence or absence of clinician documentation in </span>medical records of specific qualifying criteria (e.g., clinician documentation of patient meeting diagnostic criteria for OUD, etc). Analyses examined the association between baseline demographic and clinical characteristics with recommendations for medication and other treatments for OUD.</p></div><div><h3>Results</h3><p>Among patients with a new diagnosis of OUD, 28.7 % (n = 149) were recommended medication treatment, 52.5 % (n = 273) were recommended specialty substance use disorder (SUD) treatment, and 41.9 % (n = 218) were recommended treatment in non-SUD mental health<span> settings. In adjusted models, high likelihood of OUD (AOR 8.31, 95 % CI 4.81–15.03) was strongly associated with the clinician recommending medications for OUD, while age 56–75 (compared to &lt;35, AOR 0.36, 95 % CI 0.18–0.69), stimulant use disorder (AOR 0.28, 95 % CI 0.15–0.53), and rural residence (AOR 0.51, 95 % CI 0.30–0.85) were associated with lower likelihood of being recommended medication treatment.</span></p></div><div><h3>Conclusions</h3><p>Differentiating among patients with EHR diagnoses of OUD to identify the subset with higher likelihood of underlying OUD is important to accurately understand OUD treatment rates and disparities. However, even among patients with a clear diagnosis of OUD, medication treatment is still recommended less often than other treatments, suggesting interventions are needed to encourage clinicians to prioritize medication treatment as a first-line treatment, especially for older, rural patients and those with polysubstance use.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108827"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10634395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Emergency department interventions for opioid use disorder: A synthesis of emerging models 急诊部门对阿片类药物使用障碍的干预:新兴模型的综合
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108837
Cindy Parks Thomas , Maureen T. Stewart , Cynthia Tschampl , Kumba Sennaar , Daniel Schwartz , Judith Dey
{"title":"Emergency department interventions for opioid use disorder: A synthesis of emerging models","authors":"Cindy Parks Thomas ,&nbsp;Maureen T. Stewart ,&nbsp;Cynthia Tschampl ,&nbsp;Kumba Sennaar ,&nbsp;Daniel Schwartz ,&nbsp;Judith Dey","doi":"10.1016/j.jsat.2022.108837","DOIUrl":"10.1016/j.jsat.2022.108837","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Opioid overdose deaths are increasing, and improving access to evidence-based treatment is necessary. </span>Emergency department<span> (ED) initiation of treatment for opioid use disorder (OUD) via medications and referral to treatment is one approach that leverages a critical health care entry point for individuals with OUD. Efforts to engage patients in treatment through the ED are growing, but systematic analysis of program features as implemented and challenges across different models remains limited. Lessons from early adopter programs may benefit clinicians and others looking to offer ED-initiated treatment for OUD.</span></p></div><div><h3>Methods</h3><p>We conducted case studies of five ED-based efforts to address OUD across the United States, selected for diversity in structure, approach, and geography. We conducted telephone interviews with 37 individuals (ED physicians, ED nurses, navigators, hospital administrators, community providers, and state policymakers) affiliated with the five programs. Interviews were transcribed, coded, and analyzed using a framework analysis approach, identifying relevant lessons for replication.</p></div><div><h3>Results</h3><p>These five programs (an academic medical center, two large urban hospitals, a rural community hospital, and a community-based program) successfully implemented ED-initiated MOUD. Often a champion with knowledge of OUD treatment and a reliable connection with outpatient treatment began the program. The approach to patient identification varied from universal screening to relying on patient self-identification. Substance use treatment navigators provide crucial services but can be difficult to pay for within current reimbursement frameworks. Barriers to implementation include lack of knowledge about treatment options and effectiveness, stigma, community treatment capacity limits, and health insurance and reimbursement policies. Facilitators of success include taking a patient-centered, low-barrier approach, having a passionate champion, a strong structure with health system<span> support, and a relationship with community partners. Metrics for success vary across programs. Some programs are expanding to include treating the use of other substances such as alcohol and stimulants.</span></p></div><div><h3>Conclusion</h3><p>ED-initiated MOUD is feasible across different settings. Research and real world efforts need to promote programs that include OUD treatment as standard in ED treatment.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108837"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40510544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Predictors of engagement and retention in care at a low-threshold substance use disorder bridge clinic 低阈值物质使用障碍桥诊所护理参与和保留的预测因素
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108848
Sarah E. Wakeman , Sydney McGovern , Laura Kehoe , Martha T. Kane , Elizabeth A. Powell , Sarah K. Casey , Giovanie M. Yacorps , Jasmine R. Irvin , Windia Rodriguez , Susan Regan
{"title":"Predictors of engagement and retention in care at a low-threshold substance use disorder bridge clinic","authors":"Sarah E. Wakeman ,&nbsp;Sydney McGovern ,&nbsp;Laura Kehoe ,&nbsp;Martha T. Kane ,&nbsp;Elizabeth A. Powell ,&nbsp;Sarah K. Casey ,&nbsp;Giovanie M. Yacorps ,&nbsp;Jasmine R. Irvin ,&nbsp;Windia Rodriguez ,&nbsp;Susan Regan","doi":"10.1016/j.jsat.2022.108848","DOIUrl":"10.1016/j.jsat.2022.108848","url":null,"abstract":"<div><h3>Introduction</h3><p><span>People with substance user disorder (SUD) have frequent intersections with the health care system; however, engagement and retention in SUD care remain low, particularly for </span>marginalized populations<span>. Low-threshold treatment models that aim to eliminate barriers to care are one proposed intervention to increase access and equity in SUD treatment.</span></p></div><div><h3>Methods</h3><p>This is a retrospective, cohort study of patients treated at a low-threshold bridge clinic from 2016 to 2021. The study's primary aim was to describe patient characteristics associated with engagement, defined as two or more completed visits, and treatment retention at 60 days, defined as a completed visit 45-to-75 days after first visit. A secondary outcome was transfer to ongoing treatment after bridge clinic. The study analyzed multivariable models assessing demographic and clinical predictors for each outcome using generalized estimating equations.</p></div><div><h3>Results</h3><p><span><span>The study found that 1857 patients completed 2730 care episodes. The mean age was 38.7 years old, 70 % were male, 30 % female, 79 % White, 7 % Black, 9 % Latinx, and 97 % spoke English. Opioid use disorder (OUD) was the most common type of SUD, seen among 84 % of episodes, followed by alcohol (30 %), and stimulant use disorder (28 %). Seventy percent of bridge clinic episodes of care resulted in engagement, 38 % were retained at 60 days, and 28 % had transfer to care documented. In adjusted analyses, engagement was lower for Black patients compared to White patients and higher for patients who received </span>buprenorphine or </span>naltrexone. Retention for Black patients was also lower compared to White patients and higher for patients who were unhoused and patients who received buprenorphine or naltrexone. Transfer of care was more likely among patients who received buprenorphine.</p></div><div><h3>Conclusions</h3><p>At a low-threshold bridge clinic 70 % of patients successfully engaged in care and 38 % were retained at two months. While OUD and AUD<span> were most prevalent, stimulant use was common in this population. Patients who received buprenorphine or naltrexone had higher engagement, and retention, and those receiving buprenorphine also had higher care transfer. Black patients had lower rates of engagement and retention. Treatment providers need to adopt low-threshold SUD care models to eliminate racial disparities and address the needs of people using stimulants.</span></p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108848"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40600908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can nicotine replacement therapy be personalized? A statistical learning analysis 尼古丁替代疗法可以个性化吗?统计学习分析
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108847
Scott Veldhuizen , Laurie Zawertailo , Sarwar Hussain , Sabrina Voci , Peter Selby
{"title":"Can nicotine replacement therapy be personalized? A statistical learning analysis","authors":"Scott Veldhuizen ,&nbsp;Laurie Zawertailo ,&nbsp;Sarwar Hussain ,&nbsp;Sabrina Voci ,&nbsp;Peter Selby","doi":"10.1016/j.jsat.2022.108847","DOIUrl":"10.1016/j.jsat.2022.108847","url":null,"abstract":"<div><h3>Background</h3><p>Technology has made automated care personalization practical, but useful personalization requires information about systematic differences between individuals in the effectiveness of different interventions. Here, we used observational data to search for differences in smoking cessation<span><span> treatment outcomes associated with interactions between participant characteristics and different types and doses of </span>nicotine replacement therapy (NRT).</span></p></div><div><h3>Methods</h3><p><span>We analyzed 33,077 enrollments in a large primary care </span>smoking cessation program in Ontario, Canada. We considered 10 types and combinations of NRT, as well as the provided daily dose of nicotine. We used ridge regression to fit one main effects model and one model including all possible interactions between these measures and a range of demographic and health variables. We then compared the predictive accuracy of these models in a held-out 25 % testing subset using areas under the receiver operating characteristic curve (AUROC) and the integrated discrimination improvement index (IDI). We used random forest multiple imputation to address missing data.</p></div><div><h3>Results</h3><p>The model including main effects only modestly predicted quit success at 6 months (AUROC = 0.646, 95 % CI = 0.631, 0.660). The final model with all interactions had essentially identical performance (AUROC = 0.640, 95 % CI = 0.626, 0.654; IDI = −0.0066).</p></div><div><h3>Conclusion</h3><p>We found no evidence of meaningful interactions between treatment outcomes and participants' characteristics, NRT type, or NRT dose. Although data are observational, these findings suggest that the effectiveness of different types and doses of NRT do not vary substantially with participant characteristics. Personalization based on the overall likelihood of quit success, or using genetic or other biological data, remains possible.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108847"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40600907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment retention, return to use, and recovery support following COVID-19 relaxation of methadone take-home dosing in two rural opioid treatment programs: A mixed methods analysis 两种农村阿片类药物治疗方案中美沙酮带回家剂量放松后的治疗保留、恢复使用和康复支持:混合方法分析
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108801
Kim A. Hoffman , Canyon Foot , Ximena A. Levander , Ryan Cook , Javier Ponce Terashima , John W. McIlveen , P. Todd Korthuis , Dennis McCarty
{"title":"Treatment retention, return to use, and recovery support following COVID-19 relaxation of methadone take-home dosing in two rural opioid treatment programs: A mixed methods analysis","authors":"Kim A. Hoffman ,&nbsp;Canyon Foot ,&nbsp;Ximena A. Levander ,&nbsp;Ryan Cook ,&nbsp;Javier Ponce Terashima ,&nbsp;John W. McIlveen ,&nbsp;P. Todd Korthuis ,&nbsp;Dennis McCarty","doi":"10.1016/j.jsat.2022.108801","DOIUrl":"10.1016/j.jsat.2022.108801","url":null,"abstract":"<div><h3>Objectives</h3><p>In March 2020, the Substance Abuse and Mental Health Services Administration permitted Opioid Treatment Programs (OTPs) to relax restrictions on take-home methadone and promoted telehealth to minimize potential exposures to COVID-19. We assessed the effects of COVID-19-related changes on take-home methadone dosing in two OTPs serving five rural Oregon counties.</p></div><div><h3>Methods</h3><p>We used a mixed-methods convergent design. The OTPs extracted urine drug test (UDT) results, take-home methadone regimens, and treatment retention from the electronic health record (EHR) for patients (<em>n</em> = 377). A mixed-effects negative binomial regression model assessed patient-level differences in take-home doses before and after the COVID-19 policy changes and the associations with treatment discontinuation, and UDT positivity. Semi-structured qualitative interviews (<em>n</em> = 32) explored patient reactions to increased take-home dosing and reduced clinic visits to provide context for quantitative findings.</p></div><div><h3>Results</h3><p>The number of take-home doses increased in the post-COVID-19 period for patients engaged in treatment for more than 180 days (median: 8 vs 13 take-home doses per month, <em>p</em> = 0.011). Take-homes did not increase for patients with fewer days of treatment. Each percentage point increase in take-home dosing above what would be expected without COVID-19 policy changes was negatively associated with the percent of UDT positive for opioids (B = −0.12, CI [−0.21, −0.04], <em>p</em> = 0.005) and the probability of treatment discontinuation (aOR = 0.97, CI [0.95, 0.99], <em>p</em> = 0.003). Qualitative analysis revealed three themes explaining how increased take-home dosing supported recovery: 1) value of feeling trusted with increased responsibility; 2) reduced travel time permitted increased employment and recreation; and 3) reduced exposure to individuals less stable in recovery and potential triggers.</p></div><div><h3>Conclusions</h3><p>Take-home methadone dose relaxations were associated with increased methadone take-home doses, improved retention, and decreased UDT opioid positive results among clinically stable patients. Qualitative findings suggest that fewer take-home restrictions are feasible and desirable and do not pose safety or public health harms.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108801"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9080674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9676383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Accessibility of substance use treatment: A qualitative study from the non-service users' perspective 物质使用治疗的可及性:非服务使用者视角的质性研究
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/j.jsat.2022.108779
Laura Caris , Thijs Beckers
{"title":"Accessibility of substance use treatment: A qualitative study from the non-service users' perspective","authors":"Laura Caris ,&nbsp;Thijs Beckers","doi":"10.1016/j.jsat.2022.108779","DOIUrl":"10.1016/j.jsat.2022.108779","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite having effective treatments for substance use disorders, the majority of people with a substance use disorder do not receive treatment, which leads to adverse personal, health, and social consequences. Experiences of non-service users have hardly been investigated in the literature. This study, which we conducted in the Netherlands, assessed the barriers to and facilitators of accessibility to substance use treatment for non-service users with substance use disorders.</p></div><div><h3>Methods</h3><p>The study team conducted a total of 10 individual, semi-structured interviews with participants recruited with the help of assertive outreach teams and public health services. A topic list guided the interviews. The interviews were transcribed, and the study team performed a thematic analysis.</p></div><div><h3>Results</h3><p>Six main themes related to the health care<span> accessibility of substance use treatment emerged: treatment factors, stigmatization, personal factors, consequences of use, knowledge deficits, and social support. Personal factors, especially the non-service users' motivation, was a central determinant of whether they accessed substance use treatment. Social support and consequences of the substance use were perceived as facilitating access to treatment. Stigmatization and knowledge deficits had an important negative impact on the substance users' intrinsic motivation and thus on their ability to access health care. Specifically, stigmatization by health care professionals contributed to suboptimal treatment and recovery.</span></p></div><div><h3>Conclusions</h3><p>This study recommends interventions for health care professionals aimed at decreasing their stigma toward and knowledge deficits about substance use disorder. This study highlights the key role that primary health care providers can have in identifying substance use problems and facilitating the pathway to health care services for those with substance use disorders.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108779"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40528391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
C2: editorial board C2:编委会
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/S0740-5472(22)00140-4
{"title":"C2: editorial board","authors":"","doi":"10.1016/S0740-5472(22)00140-4","DOIUrl":"https://doi.org/10.1016/S0740-5472(22)00140-4","url":null,"abstract":"","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"141 ","pages":"Article 108858"},"PeriodicalIF":3.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0740547222001404/pdfft?md5=aa16b398d4e87857564f9eaed2bdafea&pid=1-s2.0-S0740547222001404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72114404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TOC (update) TOC(更新)
IF 3.9 2区 医学
Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI: 10.1016/S0740-5472(22)00141-6
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