Patient brokering in for-profit substance use disorder treatment: a qualitative study with people with opioid use disorder and professionals in the field.
Patient brokering in for-profit substance use disorder treatment: a qualitative study with people with opioid use disorder and professionals in the field.
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DOI：
10.1186/s12913-023-10217-z
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发表时间：
2023-11-06
影响因子：
2.8
通讯作者：
Davidson, Peter J.
中科院分区：
文献类型：
--
作者：
Clingan, Sarah E.;D'Ambrosio, Brittany M.;Davidson, Peter J.
关键词：
阿片类药物使用和阿片类药物过量死亡人数处于历史最高水平，阿片类药物使用障碍（OUD）患者的循证治疗未得到充分利用。因此，我们试图了解营利性物质使用障碍治疗行业中滥用的经验和看法，这些行业可能会使OUD患者过量用药的风险增加。从2018年11月到2019年5月，在南加州对20名OUD患者和20名在物质使用障碍（SUD）治疗领域工作的专业人员进行了一对一的半结构化访谈。一个接地理论的方法进行发现新兴的模式，从数据。出现了三个主要主题：1）财务和物质诱惑，2）鼓励营利性治疗部门使用药物，3）过量风险的贡献者。参与者报告说，耐心的经纪人会支付机票，并提供经济奖励（例如，资金），以吸引个人SUD治疗，利用保险利润，尽管初始费用。参加者报告说，有人鼓励他们在治疗前使用毒品，以满足保险条件，从而损害了真正的康复努力，增加了吸毒的诱惑。许多与会者将病人中间人交易与过量死亡人数增加联系起来，强调中间人提供药物的危险做法，促进复吸，并创造了治疗的旋转门，这加剧了戒断期后过量的风险。营利性治疗行业中的患者经纪和不道德的虐待行为导致一些OUD患者寻求金钱和住房治疗，而不是寻求治疗以停止阿片类药物的使用。有害的治疗环境被视为护理的障碍，也是康复道路上需要克服的不必要的障碍。在线版本包含补充材料，可通过10.1186/s12913-023-10217-z获得。
Opioid use and opioid overdose deaths are at an all-time high and evidence-based treatments for people with opioid use disorder (OUD) are underutilized. Therefore, we sought to understand experiences and perceptions of abuses in the for-profit substance use disorder treatment industry that could potentially put people with OUD at an increased risk for an overdose. One-on-one semi-structured interviews were conducted from November 2018 to May 2019 in Southern California with 20 people with OUD and 20 professionals who work in the substance use disorder (SUD) treatment field. A grounded theory approach was conducted to discover emerging patterns from the data. Three major themes emerged:1) financial and material enticements, 2) encouraging substance use in the for-profit treatment sector, and 3) contributors to overdose risk. Participants reported that patient brokers would pay for plane tickets and offer financial incentives (e.g., money) to attract individuals to SUD treatment, capitalizing on insurance profits despite initial expenses. Participants reported being encouraged to use drugs before treatment to meet insurance conditions, thus jeopardizing genuine recovery efforts and adding to the temptation of drug use. Many participants linked patient brokering to increased overdose deaths, emphasizing the dangerous practices of brokers providing drugs, promoting relapse, and creating a revolving door of treatment, which compounds the overdose risk after periods of abstinence. Patient brokering and unethical abuses in the for-profit treatment industry have caused some people with OUD to seek treatment for money and housing instead of seeking treatment to stop opioid use. The harmful treatment environment was seen as a barrier to care and an unwanted obstacle to overcome on the path to recovery. The online version contains supplementary material available at 10.1186/s12913-023-10217-z.
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影响因子：
5.9
作者：
Lankenau, Stephen E.;Wagner, Karla D.;Kral, Alex H.
通讯作者：
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影响因子：
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作者：
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DOI：
10.1016/j.accinf.2016.04.001
发表时间：
2016-06-01
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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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