Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City.
Adult
Aged
Analgesics, Opioid
/ therapeutic use
Attitude of Health Personnel
Attitude to Health
Baltimore
/ epidemiology
Buprenorphine
/ therapeutic use
Community Mental Health Services
Comorbidity
Craving
Criminal Law
Employment
Female
Focus Groups
Humans
Male
Mental Disorders
/ epidemiology
Mental Health Recovery
Middle Aged
Opiate Substitution Treatment
Opioid-Related Disorders
/ drug therapy
Peer Group
Qualitative Research
Social Stigma
Substance Withdrawal Syndrome
Buprenorphine
Community-based treatment
Low threshold treatment
Medication assisted treatment
Opioid use disorder
Peer support
Journal
Addictive behaviors
ISSN: 1873-6327
Titre abrégé: Addict Behav
Pays: England
ID NLM: 7603486
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
29
07
2018
revised:
23
10
2018
accepted:
14
01
2019
pubmed:
27
1
2019
medline:
14
7
2020
entrez:
26
1
2019
Statut:
ppublish
Résumé
This qualitative study identifies and describes experiences and challenges to retention of individuals with opioid use disorder (OUD) who participated in a low-threshold combined buprenorphine-peer support treatment program in Baltimore. In-depth semi-structured interviews with staff and former clients of the Project Connections Buprenorphine Program (PCBP) (9 people) and focus group discussions with current and previous clients of PCBP (7 people) were conducted. Content analysis was used to extract themes regarding barriers to enrolling and remaining in, and transitioning from the program. Primary challenges identified by the participants included struggles with cravings and symptoms of withdrawal, comorbid mental health issues, criminal justice system involvement, medication stigma, and conflicts over level of flexibility regarding program requirements and the role of employment. This study identified several obstacles clients face when seeking care through a combined buprenorphine-peer support model. Findings highlight potential programmatic factors that can be improved and additional resources that may support treatment retention rates and better outcomes. Despite challenges, low-threshold and community-based programs can increase access to effective maintenance treatment for OUD, especially among vulnerable populations who may not have access to formal health services.
Identifiants
pubmed: 30682677
pii: S0306-4603(18)30836-0
doi: 10.1016/j.addbeh.2019.01.020
pmc: PMC6528177
mid: NIHMS1025105
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Buprenorphine
40D3SCR4GZ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
14-19Subventions
Organisme : NIDA NIH HHS
ID : T32 DA007292
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH103210
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
Références
Drug Alcohol Depend. 2017 Sep 1;178:512-518
pubmed: 28719885
Addiction. 2011 Jul;106(7):1309-18
pubmed: 21320227
Psychiatr Serv. 2005 Jul;56(7):840-6
pubmed: 16020817
Drug Alcohol Depend. 2017 Dec 1;181:58-62
pubmed: 29035705
J Addict Med. 2014 Jan-Feb;8(1):40-6
pubmed: 24394496
Psychiatr Serv. 2018 Apr 1;69(4):366-369
pubmed: 29446334
N Engl J Med. 2007 Jan 11;356(2):157-65
pubmed: 17215533
Med Care. 2016 Oct;54(10):901-6
pubmed: 27623005
Addiction. 2001 May;96(5):683-90
pubmed: 11331027
Drug Alcohol Depend. 2015 Nov 1;156:57-61
pubmed: 26455554
Drug Alcohol Depend. 2016 Apr 1;161:1-8
pubmed: 26832931
J Adv Nurs. 2006 Feb;53(3):304-10
pubmed: 16441535
Health Aff (Millwood). 2017 Dec;36(12):2046-2053
pubmed: 29200340
J Acquir Immune Defic Syndr (1988). 1993 Sep;6(9):1049-56
pubmed: 8340896
J Subst Abuse Treat. 2012 Jun;42(4):400-12
pubmed: 22119180
Harv Rev Psychiatry. 2015 Mar-Apr;23(2):63-75
pubmed: 25747920
Addiction. 1998 Jan;93(1):73-92
pubmed: 9624713
Harm Reduct J. 2012 Jan 25;9:8
pubmed: 22276954
N Engl J Med. 2014 May 29;370(22):2063-6
pubmed: 24758595
Cochrane Database Syst Rev. 2009 Jul 08;(3):CD002209
pubmed: 19588333
Clin Psychol Rev. 2006 Mar;26(2):162-78
pubmed: 16406196
J Subst Abuse Treat. 2015 Oct;57:89-95
pubmed: 25986647
Subst Abus. 2018;39(4):404-409
pubmed: 29432086
Am J Public Health. 2015 Aug;105(8):e55-63
pubmed: 26066931
Asian J Psychiatr. 2014 Aug;10:10-6
pubmed: 25042945
Addict Behav. 2011 Jun;36(6):636-42
pubmed: 21276664
Addict Sci Clin Pract. 2012;7:3
pubmed: 22966409
Psychopharmacology (Berl). 2001 Dec;158(4):343-59
pubmed: 11797055
BMJ. 2017 Apr 26;357:j1550
pubmed: 28446428
Psychiatr Serv. 2007 Jun;58(6):773-81
pubmed: 17535936
J Subst Abuse Treat. 2005 Jun;28(4):321-9
pubmed: 15925266
Am J Public Health. 2018 Feb;108(2):175-181
pubmed: 29267061
Nurse Educ Today. 2004 Feb;24(2):105-12
pubmed: 14769454
Cochrane Database Syst Rev. 2014 Feb 06;(2):CD002207
pubmed: 24500948
Addict Behav. 2015 Feb;41:20-8
pubmed: 25282598
J Subst Abuse Treat. 2012 Oct;43(3):276-84
pubmed: 22301085
JAMA Intern Med. 2014 Dec;174(12):1974-81
pubmed: 25347412
J Subst Abuse Treat. 2011 Oct;41(3):252-60
pubmed: 21696913
Addict Behav. 2010 Apr;35(4):302-11
pubmed: 19932936