Substance Use Treatment Patient and Provider Perspectives on Accessing Sexual and Reproductive Health Services: Barriers, Facilitators, and the Need for Integration of Care

MacAfee, Lauren K.; Harfmann, Roxanne F.; Cannon, Lindsay M; Minadeo, Leah; Kolenic, Giselle; Kusunoki, Yasamin; Dalton, Vanessa K.

doi:10.1080/10826084.2019.1656255

Cited by 41 publications

(50 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies that detail provider perspectives also highlight structural and systematic issues, such as time constraints, funding, workloads, and the lack of cross-training between reproductive health and addiction medicine as barriers to effective care delivery (Fraser et al, 2007; Geraghty et al, 2019; MacAfee et al, 2020; Shaw et al, 2016; Syversten et al, 2018; Whittaker et al, 2016). These structural level concerns are also significant drivers of providers’ frustration and can contribute to difficulties in providing compassionate care (Sweigart, 2017).…”

Section: Literature Reviewmentioning

confidence: 99%

Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal

Nichols

Welborn

Gringle

et al. 2020

Contemporary Drug Problems

View full text Add to dashboard Cite

People who are diagnosed with a substance use disorder can experience stigmatizing interactions with health and social service providers, which may decrease both quality and continuity of care. For women with a substance-exposed pregnancy (SEP), this stigma can increase exponentially. Stigmatizing interactions can be difficult to identify due to social sanctions against expressing stigmatizing attitudes, beliefs, and behaviors and because stigma often resides in accepted cultural norms. Examining discourses around care provision can serve to identify instances of social stigma as well as illuminate the cultural norms in which they are embedded. Using data from a seven-year grounded theory study on perinatal substance use service provision, this paper reports on the perceptions and experiences of service providers working with mothers who have an SEP and illustrates complexities behind stigmatizing patient-provider interactions. Data collected included observations at meetings, workshops, and conferences addressing best practices across the continuum of care for perinatal substance use as well as interviews and focus groups with providers. The construct of “good mothering,” or hegemonic motherhood, was identified as an important cultural norm that supported social stigma and was embedded in providers’ interactions with mothers with an SEP. Discursive elements found in providers’ descriptions of perinatal substance use service work are presented and highlight the role of hegemonic motherhood as a stigmatizing agent.

show abstract

Section: Literature Reviewmentioning

confidence: 99%

Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal

Nichols

Welborn

Gringle

et al. 2020

Contemporary Drug Problems

View full text Add to dashboard Cite

show abstract

“…One approach to decreasing unintended pregnancy among women with OUD and other substance use disorders (SUD) that is receiving increased attention is to locate and integrate reproductive and sexual health services into SUD treatment programs (Klaman, Lorvick, & Jones, 2019;MacAfee et al, 2020;Wright, 2019). One of the most basic components of reproductive and sexual health services is provision of accurate information about contraception, maternal and newborn health, and HIV/AIDS among other topics (Guttmacher-Lancet Commission on Sexual and Reproductive Health Rights; Starrs et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Contraceptive Knowledge among Females and Males Receiving Medication Treatment for Opioid Use Disorder Compared to Those Seeking Primary Care

Melbostad

Badger

Rey

et al. 2020

Substance Use & Misuse

Self Cite

View full text Add to dashboard Cite

Background: Rates of unintended pregnancy among women receiving medication treatment for opioid use disorder (mOUD) are high, likely due in part to low rates of contraceptive use. Lack of knowledge about contraception may be contributing to inadequate contraceptive use. Objectives:To compare contraceptive knowledge among women and men receiving mOUD relative to a comparison group seeking primary care. Methods:We surveyed 332 reproductive-age women and men receiving mOUD or primary care with the recently validated 25-item Contraceptive Knowledge Assessment. We examined overall differences between patient groups and between females and males using two-way analyses of variance; individual item differences were tested using logistic regression. Results:The mean percent of total correct responses was lower among individuals receiving mOUD (n=167) relative to the comparison group (n=165), 47.7% vs. 53.8%, respectively (p<.001), and higher among females (n=169) relative to males (n=163), 56.1% vs. 45.2%, respectively (p<.001). Individual item analyses revealed patient group and sex differences primarily in the areas of contraceptive efficacy, attributes of contraceptive methods, and fertility awareness.

show abstract

“…Unfortunately, stigma against individuals with OUD is prevalent both in society at large and within the health care community (Volkow, 2020). Fear of judgment and mistreatment because of one's substance use commonly deters individuals from seeking health services (MacAfee et al, 2020) and may also compromise treatment outcomes. Pregnant and parenting women are particularly susceptible to the stigma and discrimination associated with addiction (Haug et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

An exploratory study of sex and gender differences in demographic, psychosocial, clinical, and substance use treatment characteristics of patients in outpatient opioid use disorder treatment with buprenorphine.

Parlier-Ahmad¹,

Martin²,

Radić³

et al. 2021

Translational Issues in Psychological Science

View full text Add to dashboard Cite

As treatment expansion in the opioid epidemic continues, it is important to examine how the makeup of individuals with opioid use disorder (OUD) is evolving. Treatment programs are increasingly utilizing buprenorphine, an effective OUD medication. This exploratory study examines sex and gender differences in psychosocial, clinical, and substance use treatment characteristics of a clinical population in outpatient medication treatment for OUD with buprenorphine. This is a secondary data analysis from a cross-sectional survey study with retrospective medical record review conducted with patients recruited from an office-based opioid treatment clinic between July-September 2019. Participants on buprenorphine for at least 28 days at time of survey completion were included (n ϭ 133). Differences between men and women were explored with Pearson 2 and Fisher's exact tests for categorical variables and T-tests for continuous variables. The sample was 55.6% women and nearly three fourths Black (70.7%). Mean days in current treatment episode was 431.6 (SD ϭ 244.82). Women were younger and more likely to be unemployed, identify as a sexual minority, and live alone with children than men. More women than men had a psychiatric comorbidity. Women reported more prescription opioid misuse while men had more heroin only opioid use. More men reported comorbid alcohol use and a history of drug overdose. One third of participants reported recent discrimination in a health care setting due to substance use. As buprenorphine-based outpatient treatment programs continue to expand, present study findings support evaluation of the unique needs of men and women in order to better tailor OUD-related services and improve treatment outcomes. What is the significance of this article for the general public?Focusing on the NIH mandate to consider sex and gender in research and clinical practice, we explored differences between men and women in the growing clinical population of patients in outpatient buprenorphine treatment for opioid use disorder

show abstract

Substance Use Treatment Patient and Provider Perspectives on Accessing Sexual and Reproductive Health Services: Barriers, Facilitators, and the Need for Integration of Care

Cited by 41 publications

References 34 publications

Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal

Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal

Contraceptive Knowledge among Females and Males Receiving Medication Treatment for Opioid Use Disorder Compared to Those Seeking Primary Care

An exploratory study of sex and gender differences in demographic, psychosocial, clinical, and substance use treatment characteristics of patients in outpatient opioid use disorder treatment with buprenorphine.

Contact Info

Product

Resources

About