Barriers to Healthcare for People Who Inject Drugs: A Survey at a Syringe Exchange Program

Miller-Lloyd, Leah; Landry, Jasmine; Macmadu, Alexandria; Allard, Ingrid; Waxman, Michael

doi:10.1080/10826084.2019.1710207

Cited by 31 publications

(17 citation statements)

References 11 publications

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“…In response to the efficacy of these programs for improved health outcomes, researchers and policymakers have begun to highlight the barriers preventing broader access and acceptance of SEPs. Similar to the current study's findings, prior research on the perspectives of PWID has found that stigma and judgment from providers is a primary barrier to accessing services (Miller-Lloyd et al, 2020). Some barriers for SEP implementation are grounded in the "not in my backyard" (NIMBY) mentality from community members opposing program placement in their neighborhoods based on fear they will cause increased criminal activity and drug use.…”

Section: Discussionsupporting

confidence: 75%

Community Perceptions of Harm Reduction and Its Implications for Syringe Exchange Policy

Sharp

Barnett

Vroom

2020

Journal of Drug Issues

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In the United States, the rising prevalence of opioid addiction has led to an increase in opioid-related overdose deaths and transmission of infectious disease. This resulted in the declaration of a national public health emergency and the need for harm reduction strategies such as syringe exchange. Florida has seen increases in blood-borne diseases and fatal/nonfatal opioid overdoses, yet harm reduction policy integration has been historically limited. To inform policy change, this study explores the perspectives of community members in Manatee County, Florida, on harm reduction services. Six focus groups were conducted with findings centralized around three emergent themes related to the implementation of a syringe exchange program: (a) awareness and acceptability; (b) facilitating factors; and (c) perceived barriers. The results of this qualitative research helped to inform the successful adoption of a local syringe exchange ordinance. Recommendations for community education and engagement regarding harm reduction policy are discussed.

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Section: Discussionsupporting

confidence: 75%

Community Perceptions of Harm Reduction and Its Implications for Syringe Exchange Policy

Sharp

Barnett

Vroom

2020

Journal of Drug Issues

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“…In addition, poor vein health as a consequence of injecting drug use can lead to chronic ulceration, particularly on the legs, which significantly impact on PWID mobility and quality of life (Hope, 2010). PWID experience multiple barriers to care access, such as lack of material resources, reluctance to disclose drug use, competing priorities and stigma (Miller Lloyd et al, 2020;Neale et al, 2008), with many selftreating their infections and/or delaying treatment seeking (Gilbert et al, 2019;Roose, 2009). This can result in increased disease severity and prolonged inpatient hospitalisation (Gilbert et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with skin and soft tissue infections among people who inject drugs in the United Kingdom: A comparative examination of data from two surveys

Doran

Harris

Hope

et al. 2020

Drug and Alcohol Dependence

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Background: People who inject drugs (PWID) are at high risk of injection-related skin and soft tissue infections (SSTI). If not treated promptly, these can lead to serious health complications, which are a considerable healthcare burden. Data from two community surveys, with different approaches, were used to assess SSTI prevalence and associated factors among PWID to inform intervention implementation. Methods: Data were analysed from two surveys, a national surveillance survey (n=2,874; 2017-18) of infections among PWID in the United Kingdom (UK) and an in-depth survey (n=455; 2018-19) of SSTI among PWID based in London, UK. Multivariable logistic regression models were constructed to ascertain the factors associated with self-reported SSTI. Results: High prevalence of SSTI were reported in both samples: 52 % of participants from the national surveillance survey reported having SSTI within the preceding 12 months and 65 % of the London sample reported a lifetime history of SSTI. The factors associated with SSTI in both surveys were similar, including older age; number of years injecting; number of attempts required to inject into the vein; injecting into the hands, feet, groin or neck and re-using or sharing needles/syringes. Conclusions: The number of PWID reporting SSTI in the UK is concerningly high. The two surveys used different recruitment approaches but found similar associations. We provide strong evidence of a relationship between venous access difficulty and SSTI. To stem the increase of SSTI and related complications in the UK, it is crucial that interventions attend to the underlying causes of venous damage among PWID.

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“…Thus, we suggest under-diagnosing of circulatory conditions in the OST patient group, which could be suggested when interpreting some studies analyzing healthcare seeking patterns and barriers to the use of healthcare among people with SUD [ 18 , 24 , 25 , 26 , 27 ]. Further, we do not suspect that poor documentation explains the low diagnosis rates, since diagnoses in the national Swedish inpatient register have been shown to be valid in 85–95% of cases [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to OST patients having increased comorbidities compared to the general population, many of them lack a primary healthcare (PHC) contact. Previous research has shown that people who use illicit drugs are medically underserved and experience barriers towards healthcare seeking [ 24 , 25 , 26 , 27 ]. A recent study of OST patients in Malmö, Sweden, demonstrates that many worry about their somatic health and have had different health issues in the last year for which they have not contacted any healthcare services [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare Contacts Regarding Circulatory Conditions among Swedish Patients in Opioid Substitution Treatment, with and without On-Site Primary Healthcare

Bäckström

Troberg

Håkansson

et al. 2021

IJERPH

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Patients in Opioid Substitution Treatment (OST) have increased mortality and morbidity, with circulatory conditions suggested to be a contributing factor. Since OST patients tend to have unmet physical healthcare needs, a small-scale intervention providing on-site primary healthcare (PHC) in OST clinics was implemented in Malmö, Sweden in 2016. In this study, we assessed registered circulatory conditions and healthcare utilization in OST patients with and without use of on-site PHC. Patients from four OST clinics in Malmö, Sweden, were recruited to a survey study in 2017–2018. Medical records for the participants were retrieved for one year prior to study participation (n = 192), and examined for circulatory diagnoses, examinations and follow-ups. Patients with and without on-site PHC were compared through descriptive statistics and univariate analyses. Eighteen percent (n = 34) of the sample had 1≤ registered circulatory condition, and 6% (n = 12) attended any clinical physiology examination or follow-up, respectively. Among patients utilizing on-site PHC (n = 26), the numbers were 27% (n = 7) for circulatory diagnosis, 15% (n = 4) for examinations, and 12% (n = 3) for follow-up. OST patients seem underdiagnosed in regard to their circulatory health. On-site PHC might be a way to diagnose and treat circulatory conditions among OST patients, although further research is needed.

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Barriers to Healthcare for People Who Inject Drugs: A Survey at a Syringe Exchange Program

Cited by 31 publications

References 11 publications

Community Perceptions of Harm Reduction and Its Implications for Syringe Exchange Policy

Community Perceptions of Harm Reduction and Its Implications for Syringe Exchange Policy

Factors associated with skin and soft tissue infections among people who inject drugs in the United Kingdom: A comparative examination of data from two surveys

Healthcare Contacts Regarding Circulatory Conditions among Swedish Patients in Opioid Substitution Treatment, with and without On-Site Primary Healthcare

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