Designing an “Ideal” Substance Use Disorder Treatment Center: Perspectives of People Who Have Utilized Medications for Opioid Use Disorder

Andraka‐Christou, Barbara; Randall-Kosich, Olivia; Totaram, Rachel

doi:10.1177/1049732320971231

Cited by 16 publications

(14 citation statements)

References 54 publications

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“…This includes offering a continuum of co-located treatment, harm reduction, and social services that can meet individuals where they are. This would help facilitate access to life-saving services and greater socioeconomic stability [ 28 , 29 ]. This may be particularly important for individuals with multiple vulnerabilities, as well as during emergencies—such as the COVID-19 pandemic—when minimizing travel and co-locating access to multiple health and social services is key [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs

et al. 2022

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Background 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. Methods 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. Results 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. Conclusions 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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Section: Discussionmentioning

confidence: 99%

Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs

et al. 2022

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“…Furthermore, trusted and supportive relationships with OAT providers were seen as key factors for reducing participants’ risk of relapse, and in turn, potential re-incarceration. Such positive client-centred supportive care delivered by non-judgemental OAT staff has been associated with increased treatment retention and success in other studies (Andraka-Christou et al, 2020 ; Fox, Jakubowski et al, 2019 ; Jackson, 2021 ; Maina et al, 2019 ; Marchand et al, 2018 ). For instance, one US study that examined the effectiveness of a transition clinic-based primary care program for justice-involved women who were re-entering into the community identified the importance of trauma-informed care and supportive staff in treatment engagement and retention (Thomas et al, 2019 ).…”

Section: Discussionmentioning

confidence: 77%

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

Russell

Pang

Nafeh

et al. 2022

International Journal of Qualitative Studies on Health and Well

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Introduction Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.

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Section: Discussionmentioning

confidence: 99%

“…Few studies have specifically examined individual-level treatment preferences among people who use opioids (Andraka-Christou et al, 2021). Andraka-Christou and colleagues interviewed people with a history of OUD and MOUD treatment utilization from eight US states to learn their preferences for substance use treatment (Andraka-Christou et al, 2021). Key preferences included a harm reduction approach, multiple integrated levels of care that included counseling, self-help, and peer support, and a menu of treatment services including MOUD options (Andraka-Christou et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Andraka-Christou and colleagues interviewed people with a history of OUD and MOUD treatment utilization from eight US states to learn their preferences for substance use treatment (Andraka-Christou et al, 2021). Key preferences included a harm reduction approach, multiple integrated levels of care that included counseling, self-help, and peer support, and a menu of treatment services including MOUD options (Andraka-Christou et al, 2021). Policies that require integration of multiple MOUD modalities and behavioral treatments within the same site could help retain and track patients’ progress even as they feel a need to switch or try alternate medications to find the solution that best works for them in their recovery.…”

Section: Discussionmentioning

confidence: 99%

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Treatment Experiences Among People Who Use Opioids: A Social Ecological Approach

et al. 2022

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The prevalence of opioid use disorder (OUD) and surge in overdose deaths remain key public health concerns. Despite evidence supporting the efficaciousness of medications for opioid use disorder, most people with OUD do not receive treatment. In this qualitative study, semi-structured interviews were conducted with 35 adults in a northeastern city to learn about their experiences with substance use treatment. Qualitative data were analyzed using an inductive thematic content analysis approach, and a social ecological model was applied to examine contextual factors affecting participants’ experiences accessing and engaging in treatment. While we organized our findings following the individual, interpersonal, community, and society levels of the socio-ecological model, we also observed overlap and interconnectedness between and across these levels. Our findings suggest that retention in treatment often depends upon personal motivation, treatment availability, the match of the treatment modality to an individual’s needs, and social support. A person-centered approach is needed to promote individualized care and tailor treatment components to the patient’s needs.

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Designing an “Ideal” Substance Use Disorder Treatment Center: Perspectives of People Who Have Utilized Medications for Opioid Use Disorder

Cited by 16 publications

References 54 publications

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

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

Treatment Experiences Among People Who Use Opioids: A Social Ecological Approach

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