女性与阿片类药物使用障碍的治疗:从康复中的女性、曾经尝试过戒毒治疗的女性以及卫生和刑事司法专业人员的角度看治疗成功的因素

Emma M Skogseth, Kristina Brant, Eric Harrison, Hannah B. Apsley, Max Crowley, Robert P Schwartz, Abenaa A Jones
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摘要

阿片类药物使用失调症(OUD)在女性中的发病率过高,与阿片类药物相关的过量死亡在女性中的增长速度也令人震惊,这凸显了扩大有效减低伤害和治疗方法的明确需求。研究支持将阿片类药物使用障碍(MOUD)药物治疗作为一种有效的干预措施;然而,由于此类药物的使用率较低,因此有必要确定促进女性接受和保留 MOUD 治疗的因素。因此,本研究通过对受影响妇女以及卫生和刑事司法专业人员的观点进行三角测量,对治疗成功的因素进行研究。2022 年 5 月至 7 月期间,研究人员对曾经或正在使用 MOUD 的康复女性(10 人)、曾经终止 MOUD 计划但目前正在使用阿片类药物的女性(10 人)、SUD 治疗专业人员(12 人)以及与使用阿片类药物的女性打交道的刑事司法专业人员(10 人)进行了访谈(42 人)。对所有参与者的访谈都围绕着她们的背景、对 MOUD 治疗的障碍和促进因素的认识,以及接受药物使用障碍治疗的女性所特有的问题。我们采用了专题定性数据分析流程来分析访谈记录。参与者从三个方面强调了治疗成功的因素:(1)内部过程(包括提高自我效能和设定现实的目标),(2)获得资源(包括物质资源,如食物和住所、教育资源和社会支持),以及(3)治疗结构(如治疗类型和方案)。内部程序、获得资源和治疗结构有助于 OUD 妇女在 MOUD 治疗中取得成功。在有组织的支持下,分享经验并制定切实可行的目标,可以促进接受感和能力的增强,从而提高治疗成功的几率。此外,法院系统可以推广以证据为基础、以心理创伤为导向的药物使用治疗,并提供与药物使用相关的教育资源,从而使更多妇女受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Women and Treatment for Opioid Use Disorder: Contributors to Treatment Success From the Perspectives of Women in Recovery, Women With Past Attempts in Drug Treatment, and Health and Criminal Justice Professionals
The disproportionate incidence of opioid use disorder (OUD) and the alarming increases in opioid-related overdose deaths among women highlight a clear need for the expansion of effective harm reduction and treatment practices. Research supports medications for opioid use disorders (MOUD) as an effective intervention; however, with low rates of utilization of such, there is a need to identify factors that facilitate MOUD treatment uptake and retention for women. Thus, the current study examines contributors to treatment success through the triangulation of perspectives from affected women as well as health and criminal justice professionals. Interviews (N = 42) were conducted from May to July 2022 with women in recovery who previously used or currently use MOUD (N = 10), women who currently use opioids who terminated a MOUD program previously (N = 10), SUD treatment professionals (N = 12), and criminal justice professionals who work with women who use opioids (N = 10). Interviews for all participants centered around their backgrounds, perceived barriers and facilitators to MOUD treatment, and issues specific to women in treatment for substance use disorder. We used a thematic qualitative data analysis process to analyze transcripts. Participants highlighted contributors to treatment success from 3 domains: (1) internal processes (including promoting self-efficacy and setting realistic goals), (2) access to resources (including material resources, such as food and shelter, educational resources and social support), and (3) treatment structure (such as treatment type and protocol). Internal processes, access to resources, and treatment structure contribute to MOUD treatment success for women with OUD. Structured support where experiences are shared, and realistic goals are set, may promote feelings of acceptance and empowerment, thereby bolstering chances of treatment success. Additionally, the court system can promote evidence-based and trauma-informed substance use treatment and provide accessible educational resources related to substance use to extend these benefits to more women.
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