"You're Not Supposed to be on it Forever": Medications to Treat Opioid Use Disorder (MOUD) Related Stigma Among Drug Treatment Providers and People who Use Opioids.
"You're Not Supposed to be on it Forever": Medications to Treat Opioid Use Disorder (MOUD) Related Stigma Among Drug Treatment Providers and People who Use Opioids.
复制标题
DOI：
10.1177/11782218221103859
复制
发表时间：
2022
影响因子：
2.1
通讯作者：
Green Montaque, Helena Danielle
中科院分区：
文献类型：
--
作者：
Dickson-Gomez, Julia;Spector, Antoinette;Weeks, Margaret;Galletly, Carol;McDonald, Madelyn;Green Montaque, Helena Danielle
阿片类药物滥用（OUD）通过处方阿片类药物滥用，海洛因和非法制造的芬太尼使用在过去20年中急剧增加。治疗阿片类药物使用障碍（MOUD）的药物被认为是治疗阿片类药物使用障碍的金标准，但摄取率仍然很低。最近，Madden认为，除了对物质使用和SUD患者的污名化外，MOUD也被污名化，她将干预污名化的过程标记为与条件污名化（即SUD污名化）区分开来。在本文中，我们从使用阿片类药物（PWUO）的人和在提供或推荐人们接受药物治疗方面发挥一定作用的关键线人的角度研究了MOUD相关的污名。提供者和PWUO经常将MOUD视为一种药物取代另一种药物，这阻碍了提供者推荐和PWUO接受MOUD。MOUD的耻辱也表现在供应商对MOUD转移的过度恐惧。MOUD被接受为合法治疗的程度各不相同，并影响了治疗提供者对药物治疗目标的看法，以及MOUD应使用的时间长度，许多人认为MOUD只应用作临时工具，而PWESTs则用于其他治疗目标。这导致治疗一段时间后MOUD逐渐减少。一些提供者还表示不信任MOUD，因为他们以前有过过量使用阿片类药物治疗疼痛的经历，导致了目前的危机。这项研究的结果表明，如果不解决药物治疗提供者和寻求治疗的PWUO之间的MOUD耻辱，PWUO对MOUD的比例不太可能增加。
Opioid use disorder (OUD) through prescription opioid misuse, heroin, and illicitly manufactured fentanyl use has increased dramatically in the past 20 years. Medications to treat opioid use disorder (MOUD) is considered the gold standard for treating opioid use disorders but uptake remains low. Recently, Madden has argued that in addition to the stigma assigned to substance use and people with SUD, MOUDs also are stigmatized, a process she labels intervention stigma to distinguish it from condition stigma (ie, stigma of SUD) . In this paper, we examine MOUD related stigma from the perspective of people who use opioids (PWUO) and key informants who play some role in providing or referring people to drug treatment. Providers and PWOU often viewed MOUD as one drug replacing another which discouraged providers from recommending and PWUO from accepting MOUD. MOUD stigma was also expressed by providers’ exaggerated fear of MOUD diversion. The extent to which MOUD was accepted as a legitimate treatment varied and influenced treatment providers’ perceptions of the goals of drug treatment and the length of time that MOUD should be used with many feeling that MOUD should only be used as a temporary tool while PWOU work on other treatment goals. This led to tapering off of MOUD after some time in treatment. Some providers also expressed mistrust of MOUD stemming from their previous experiences with the over-prescription of opioids for pain which led to the current crisis. Results from this study suggest that the proportion of PWUO on MOUD is unlikely to increase without addressing MOUD stigma among drug treatment providers and PWUO seeking treatment.
登录
查看更多内容
DOI：
10.1016/j.drugpo.2020.102701
发表时间：
2020-11
期刊：
The International journal on drug policy
影响因子：
--
作者：
Cooper HL;Cloud DH;Freeman PR;Fadanelli M;Green T;Van Meter C;Beane S;Ibragimov U;Young AM
通讯作者：
Young AM
对患者和提供者对阿片类药物使用障碍的治疗药物的观点的系统评价。
影响因子：
3.9
作者：
Cioe K;Biondi BE;Easly R;Simard A;Zheng X;Springer SA
通讯作者：
Springer SA
在Covid-19期间接受美沙酮维护治疗的人中的剂量经历。
影响因子：
3.9
作者：
Figgatt MC;Salazar Z;Day E;Vincent L;Dasgupta N
通讯作者：
Dasgupta N
影响因子：
3.5
作者：
Andraka-Christou, Barbara;Totaram, Rachel;Randall-Kosich, Olivia
通讯作者：
Randall-Kosich, Olivia
影响因子：
4.2
作者：
Kim, Theresa W.;Saitz, Richard;Samet, Jeffrey H.
通讯作者：
Samet, Jeffrey H.