Treatment trajectories and barriers in opioid agonist therapy for people who inject drugs in rural Puerto Rico.
Treatment trajectories and barriers in opioid agonist therapy for people who inject drugs in rural Puerto Rico.
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DOI：
10.1016/j.jsat.2021.108347
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发表时间：
2021-08
影响因子：
3.9
通讯作者：
Dombrowski K
中科院分区：
文献类型：
--
作者：
Abadie R;McLean K;Habecker P;Dombrowski K
研究表明，治疗阿片类药物使用障碍（mod）的药物具有积极作用，包括减少艾滋病毒和丙型肝炎病毒的传播，但注射吸毒者（PWID）获得药物的重要障碍仍然存在。障碍包括缺乏社会和家庭支持、官僚主义、距离治疗很远、贫穷和无家可归。然而，我们对这些障碍如何相互作用以形成PWID的药物治疗获取和保留知之甚少。我们使用了定性方法，使用了2019年对居住在波多黎各农村的31名活跃PWID进行的一项研究的数据集。该研究收集了有关治疗轨迹的人种学数据和叙述，以记录PWID患者在接受和退出治疗时的生活经历。参与者至少18岁；87.7%为男性，平均年龄44.1岁，平均首次注射年龄22岁。参与者认为，无家可归、缺乏适当的身份证件或其他身份证明文件，以及以前的不良经历是进入和保留治疗的主要障碍。此外，PWID认为mod只是用非法药物代替合法药物，同时通过长期使患者接受治疗而进一步加深药物依赖，这构成了进入的额外障碍。本研究的结果表明，在波多黎各农村的PWID中，获取和保留mod的障碍受到贫困和其他形式脆弱性的严重影响。增加获取和保留的政策不应孤立地考虑障碍，而应综合考虑许多因素。
Research has shown medication for opioid use disorder (MOUD) to have positive effects, including reducing HIV and HCV transmission, but important barriers to access remain among people who inject drugs (PWID). Barriers include lack of social and familial support, bureaucracy, distance to treatment, poverty, and homelessness. However, we know little about how these barriers interact with each other to shape PWID’s drug treatment access and retention. We used qualitative methods with a dataset from a study conducted during 2019 with 31 active PWID residing in rural Puerto Rico. The study gathered ethnographic data and narratives about treatment trajectories to document the lived experiences of PWID as they moved in and out of treatment. Participants were at least 18 years old; 87.7% were male, the mean age was 44.1 years, and the mean age at first injection was 22 years. Participants identified homelessness, lack of proper ID or other identifying documents, and previous negative experiences with MOUD as the main barriers to treatment entry and retention. In addition, PWID’s belief that MOUD simply substitutes an illegal drug for a legal one, while furthering drug dependence by chronically subjecting patients to treatment, constitutes an additional barrier to entry. Findings from this study demonstrate that MOUD barriers to access and retention compound and are severely affected by poverty and other forms of vulnerability among PWID in rural Puerto Rico. Policies to increase access and retention should consider barriers not in isolation but as an assemblage of many factors.
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DOI：
10.3109/09687637.2015.1016397
发表时间：
2015
期刊：
Drugs (Abingdon, England)
影响因子：
--
作者：
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通讯作者：
Altice FL
影响因子：
5.5
作者：
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通讯作者：
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影响因子：
4.2
作者：
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通讯作者：
Wood, E
DOI：
10.1016/j.drugpo.2012.10.003
发表时间：
2013-11-01
期刊：
The International journal on drug policy
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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