"You are not clean until you're not on anything": Perceptions of medication-assisted treatment in rural Appalachia.
"You are not clean until you're not on anything": Perceptions of medication-assisted treatment in rural Appalachia.
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DOI：
10.1016/j.drugpo.2020.102704
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Go VF
中科院分区：
文献类型：
--
作者：
Richard EL;Schalkoff CA;Piscalko HM;Brook DL;Sibley AL;Lancaster KE;Miller WC;Go VF
药物辅助治疗（MAT）是治疗阿片类药物使用障碍（OUD）的循证策略。然而，与MAT相关的污名化减少了MAT的使用，农村地区的MAT使用率特别低。迄今为止，尚未描述农村地区对MAT的看法和态度。这项定性研究的目的是表征的看法和态度MAT和环境因素，这些意见在阿巴拉契亚俄亥俄州。从2018年2月至7月，在俄亥俄州阿巴拉契亚的三个农村县对34名利益相关者（12名医疗保健专业人员，12名物质使用治疗提供者，7名执法人员和司法官员以及3名相关组织成员）进行了半结构化访谈。访谈被转录，编码和分析，以表征风险环境和参与者的看法和态度MAT。与会者表达或描述了该地区普遍存在的与MAT相关的污名。参与者一致描述了影响耻辱的环境的三个要素：（1）“保守”文化，其中禁欲是成功康复所必需的;（2）担心药物转移和滥用;（3）将MAT排除在刑事司法系统之外的毒品法庭政策。需要通过有效的循证治疗来解决与MAT相关的污名问题，以应对阿片类药物的流行。
Medication-assisted treatment (MAT) is an evidence-based strategy to treat opioid use disorder (OUD). However, MAT-related stigma reduces MAT uptake, which is particularly low in rural areas. To date, perceptions and attitudes towards MAT in rural settings have not been described. This qualitative study aims to characterize perceptions and attitudes towards MAT and the environmental factors contributing to these views in Appalachian Ohio. From February to July 2018, semi-structured interviews were conducted with 34 stakeholders (12 healthcare professionals, 12 substance use treatment providers, 7 law enforcement agents and judicial officials, and 3 members of relevant organizations) in three rural counties in Appalachian Ohio. Interviews were transcribed, coded, and analyzed to characterize the risk environment and participants’ perceptions and attitudes towards MAT. Participants expressed or described pervasive MAT-related stigma in the region. Participants consistently described three elements of the environment affecting stigma: (1) a “conservative” culture in which abstinence is necessary to be in recovery successfully; (2) fear of medication diversion and abuse; (3) drug court policies that keep MAT out of the criminal justice system. MAT-related stigma will need to be addressed to tackle the opioid epidemic through evidence-based treatment effectively.
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影响因子：
4.2
作者：
Cicero, Theodore J.;Ellis, Matthew S.;Kurtz, Steven P.
通讯作者：
Kurtz, Steven P.
影响因子：
3.9
作者：
Lavonas, Eric J.;Severtson, S. Geoffrey;Dart, Richard C.
通讯作者：
Dart, Richard C.
影响因子：
6
作者：
Larney, Sarah;Toson, Barbara;Dolan, Kate
通讯作者：
Dolan, Kate
影响因子：
4.2
作者：
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通讯作者：
Knudsen, Hannah K.
影响因子：
158.5
作者：
Fudala, PJ;Bridge, TP;Tusel, D
通讯作者：
Tusel, D