A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

被引:10
|
作者
Russell, Cayley [1 ]
Ali, Farihah [1 ]
Nafeh, Frishta [1 ]
LeBlanc, Sean [2 ]
Imtiaz, Sameer [1 ]
Elton-Marshall, Tara [1 ,3 ,4 ,5 ,6 ]
Rehm, Jurgen [1 ,3 ,5 ,7 ,8 ,9 ,10 ]
机构
[1] Inst Mental Hlth Policy Res, Ctr Addict & Mental Hlth CAMH, 2035-33 Ursula Franklin St, Toronto, ON M5S 2S1, Canada
[2] Drug Users Advocacy League DUAL, 216 Murray St, Ottawa, ON K1N 5S6, Canada
[3] Univ Toronto, Dalla Lana Sch Publ Hlth, 155 Coll St, Toronto, ON M5T 3M7, Canada
[4] Western Univ, Schulich Sch Med & Dent, Dept Epidemiol & Biostat, 1151 Richmond St, Richmond, ON M6A 5C1, Canada
[5] Ctr Addict & Mental Hlth CAMH, Campbell Family Mental Hlth Res Inst, 250 Coll St, Toronto, ON M5T 1R8, Canada
[6] Lakehead Univ, Dept Hlth Sci, 955 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada
[7] Univ Toronto, Dept Psychiat, 1 Kings Coll Circle, Toronto, ON M5S 1A8, Canada
[8] Univ Toronto, Inst Med Sci IMS, 1 Kings Coll Circle, Toronto, ON M5S 1A8, Canada
[9] Tech Univ Dresden, Inst Klin Psychol & Psychotherapie, Chemnitzer Str 46, D-01187 Dresden, Germany
[10] IM Sechenov First Moscow State Med Univ, Dept Int Hlth Projects, Inst Leadership & Hlth Management, Bolshaya Pirogovskaya Ulitsa,19C1, Moscow 119146, Russia
基金
加拿大健康研究院;
关键词
Addiction; Harm reduction; Needs; Ontario; People who use drugs; Policy; Service provision; Substance use; Treatment; MENTAL-HEALTH; USE DISORDERS; SUPERVISED CONSUMPTION; ABUSE TREATMENT; CARE; BARRIERS; INTERVENTIONS; STIGMA; ADULTS; HIV;
D O I
10.1186/s12889-021-12104-w
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background People who use drugs (PWUD) often have complex health and social support needs related to substance use, yet face numerous barriers to service access, resulting in unmet treatment needs and a corresponding gap in treatment. While initiatives to scale up substance use services for PWUD in Canada - and Ontario - have been undertaken, these have excluded PWUD' perspectives, and their needs have largely been defined by other actors. As end-users of services, PWUD' perspectives are vital to understanding what services are required, and whether existent services are adequate, appropriate and effective. Thus, the present study aimed to elicit in-depth knowledge from PWUD with lived experience of accessing services to better understand their unmet treatment and service needs, towards closing the service and treatment gap in Ontario. Methods This qualitative study included one-on-one interviews conducted with a cohort of n = 45 adult PWUD with substance use and treatment experience in Ontario, Canada. Participants were recruited from substance use services based on ConnexOntario's directory of all provincial addiction services, as well as by word-of-mouth. Questions focused on participants' experiences and perspectives on substance use services towards understanding their service needs. Data underwent an inductive thematic analysis based on key themes that emerged. Results Participants commonly engaged in polysubstance use, and identified a number of unmet substance use service needs including complex factors within the current service system that influenced access to available programs. Specifically, participants suggested the need to address stigmatization and system fragmentation, increase service provision and capacity, and scale up specific services and related supports such as harm reduction, counseling, treatment, and housing. Conclusions This study identified PWUD' needs in relation to substance use service provision in Ontario, Canada, and highlighted important areas for policy change and program planning and implementation. Concrete recommendations include the development of a government-funded, low-barrier, comprehensive and integrated service delivery and referral models that include PWUD as collaborators and program facilitators to ensure that services are as accessible, effective, and cohesive as possible. Results from this study can be used to enhance provincial substance use treatment and service provision.
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页数:14
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