Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs.
Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs.
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DOI：
10.1186/s12954-022-00676-8
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发表时间：
2022-08-24
影响因子：
4.4
通讯作者：
Saloner, Brendan
中科院分区：
文献类型：
--
作者：
Krawczyk, Noa;Allen, Sean T.;Schneider, Kristin E.;Solomon, Keisha;Shah, Hridika;Morris, Miles;Harris, Samantha J.;Sherman, Susan G.;Saloner, Brendan
关键词：
药物滥用治疗和减少危害服务是减少药物滥用和药物过量危害综合战略的重要组成部分。然而，这些服务历来都是孤立的，因此需要更好地了解为吸毒者 (PWUD) 提供服务的计划如何整合这些服务。在这项研究中，我们比较了药物滥用服务提供商的多州样本提供的治疗和减少伤害服务，并评估了它们与 COVID-19 大流行早期所服务的客户的特征和需求的契合程度。我们收集了在美国十个州提供减少伤害和/或治疗服务的项目的便利样本。项目主管参与了一项评估其项目所提供服务的调查。我们还招募了这些项目的客户参与一项调查，评估一系列社会人口和健康特征、物质使用行为和卫生服务利用情况。然后，我们交叉比较了与通过这些计划提供的服务相关的客户特征和行为。我们收集并分析了参加 18 个项目的 511 名客户的数据，我们将这些项目分类为提供阿片类药物使用障碍药物治疗 (MOUD) (N = 6)、注射器服务项目 (SSP) (N = 8)，或同时提供 MOUD 和 SSP (N = 4)。所有计划都提供一系列治疗和减少伤害服务，其中 MOUD 和 SSP 计划提供最广泛的服务。所提供的服务与客户报告的特征和行为之间存在差异：在不提供 SSP 的 MOUD 项目中，80% 的客户主动使用药物，50% 注射药物；在不提供 MOUD 的情况下提供 SSP 的项目中，40% 的客户寻求戒毒治疗服务。大约一半的客户失业且住房不稳定，但很少有项目提供直接的社会服务。在许多方面，现有计划无法满足 PWUD 的服务需求。投资创新模式，赋予客户权力，整合一系列方便、灵活的治疗、减少伤害和社会服务，可以为建立更有效、更公平的服务体系铺平道路，该体系考虑残疾人的长期健康。
Substance use treatment and harm reduction services are essential components of comprehensive strategies for reducing the harms of drug use and overdose. However, these services have been historically siloed, and there is a need to better understand how programs that serve people who use drugs (PWUD) are integrating these services. In this study, we compared treatment and harm reduction services offered by a multistate sample of substance use service providers and assessed how well they align with characteristics and needs of clients they serve early in the COVID-19 pandemic. We recruited a convenience sample of programs that deliver harm reduction and/or treatment services in ten US states. Program directors participated in a survey assessing the services offered at their program. We also recruited clients of these programs to participate in a survey assessing a range of sociodemographic and health characteristics, substance use behaviors, and health service utilization. We then cross-compared client characteristics and behaviors relative to services being offered through these programs. We collected and analyzed data from 511 clients attending 18 programs that we classified as either offering treatment with medications for opioid use disorder (MOUD) (N = 6), syringe service programs (SSP) (N = 8), or offering both MOUD and SSP (N = 4). All programs delivered a range of treatment and harm reduction services, with MOUD & SSP programs delivering the greatest breadth of services. There were discrepancies between services provided and characteristics and behaviors reported by clients: 80% of clients of programs that offered MOUD without SSP actively used drugs and 50% injected drugs; 40% of clients of programs that offered SSP without MOUD sought drug treatment services. Approximately half of clients were unemployed and unstably housed, but few programs offered direct social services. In many ways, existing programs are not meeting the service needs of PWUD. Investing in innovative models that empower clients and integrate a range of accessible and flexible treatment, harm reduction and social services can pave the way for a more effective and equitable service system that considers the long-term health of PWUD.
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DOI：
10.37765/ajmc.2020.43747
发表时间：
2020-07
期刊：
The American journal of managed care
影响因子：
--
作者：
Polsky D;Sen AP;Arsenault S
通讯作者：
Arsenault S
影响因子：
158.5
作者：
Peters, Philip J.;Pontones, Pamela;Duwve, Joan M.
通讯作者：
Duwve, Joan M.
影响因子：
6.6
作者：
Park, Ju Nyeong;Rouhani, Saba;Sherman, Susan G.
通讯作者：
Sherman, Susan G.
DOI：
10.1016/j.drugpo.2021.103140
发表时间：
2021-06
期刊：
The International journal on drug policy
影响因子：
--
作者：
Krawczyk N;Bunting AM;Frank D;Arshonsky J;Gu Y;Friedman SR;Bragg MA
通讯作者：
Bragg MA
影响因子：
5.5
作者：
Daniels, Amy M.;Salisbury-Afshar, Elizabeth;Fingerhood, Michael I.
通讯作者：
Fingerhood, Michael I.