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

BMC Public Health

Sean LeBlanc¹  Farihah Ali²  Sameer Imtiaz²  Cayley Russell²  Frishta Nafeh²  Jürgen Rehm³  Tara Elton-Marshall⁴ 

[1] Drug Users Advocacy League (DUAL), 216 Murray St, Ottawa, K1N 5S6, Ontario, Canada;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), #2035-33 Ursula Franklin St, M5S 2S1, Toronto, Ontario, Canada;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), #2035-33 Ursula Franklin St, M5S 2S1, Toronto, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College St, M5T 3M7, Toronto, Ontario, Canada;Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 250 College St, M5T 1R8, Toronto, Ontario, Canada;Department of Psychiatry, University of Toronto, 1 King’s College Circle, M5S 1A8, Toronto, Ontario, Canada;Institute of Medical Science (IMS), University of Toronto, 1 King’s College Circle, M5S 1A8, Toronto, Ontario, Canada;Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany;Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Bol’shaya Pirogovskaya Ulitsa, 19с1, 119146, Moscow, Russia;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), #2035-33 Ursula Franklin St, M5S 2S1, Toronto, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College St, M5T 3M7, Toronto, Ontario, Canada;Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, M6A 5C1, London, Ontario, Canada;Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 250 College St, M5T 1R8, Toronto, Ontario, Canada;Department of Health Sciences, Lakehead University, 955 Oliver Road, P7B 5E1, Thunder Bay, Ontario, Canada;

关键词: Addiction;    Harm reduction;    Needs;    Ontario;    People who use drugs;    Policy;    Service provision;    Substance use;    Treatment;   

DOI  :  10.1186/s12889-021-12104-w

来源: Springer

【 摘 要 】

BackgroundPeople 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.MethodsThis 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.ResultsParticipants 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.ConclusionsThis 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.

【 授权许可】

CC BY