How do international laws affect citizens' willingness to accept refugees? In full and partial democracies, citizens' attitudes can influence national policy. A growing literature suggests that international institutions can influence citizens' attitudes on foreign policy issues, and therefore lead to policy change, but those studies are almost entirely confined to domestic human rights and U.S.-based respondents; none consider refugee policy. Using data from a survey experiment administered in September 2017 via face-to-face interviews with 1,335 citizens of Turkey, we investigate how international norms affect citizens' willingness to accept refugees. Our findings are surprising: reminding people about the government's responsibility under the Refugee Convention to accept refugees triggers a backfire effect, decreasing support for accepting them. This effect appears driven by respondents who support the incumbent AKP Party and by lower-educated respondents. We therefore provide evidence that international refugee law-and perhaps international institutions generally-can trigger a political backlash, undermining the very policies that they promote.
Objective: Although primary care settings have benefits for implementing office-based opioid treatment (OBOT) programs with buprenorphine, few studies have examined the impact on patient retention beyond 12 months. The objective of this study is to assess long-term outcomes of buprenorphine treatment for opioid use disorder (OUD) integrated into comprehensive primary care treatment at a family medicine practice. Methods: A retrospective chart review of patients diagnosed with OUD who received treatment with buprenorphine between December 2006 and January 2018 was conducted at private family medicine practice in semirural Upstate New York. Patients were seen continuously by the same provider. The primary outcome was retention in OBOT at 3 years. Results: The primary outcome was met by 47.4% of included patients (N = 152). Mean retention in care for all patients was 24.3 months. More than three quarters of patients (77%) had a least one psychiatric comorbidity managed by the practice, most commonly depression (59.9%). Self-reported history of intravenous drug use at baseline was associated with a higher likelihood of patient dropout at year 1 (odds ratio, 2.99; 95% confidence interval, 1.39-6.44; P = 0.004) and year 2 (odds ratio, 2.46; 95% confidence interval, 1.15-5.28; P = 0.019), with no difference observed at year 3. Conclusions: Office-based opioid treatment with buprenorphine in a family medicine practice setting resulted in high retention rates, emphasizing the importance of continuity of care and integration of primary care within the OUD treatment model. Further research is needed on barriers to implementation of OBOT among family medicine providers.
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