Designing an “Ideal” Substance Use Disorder Treatment Center: Perspectives of People Who Have Utilized Medications for Opioid Use Disorder

Abstract

Treatment preferences of people with opioid use disorder (OUD) have been underexplored, especially among those with a history of utilizing medications for opioid use disorder (MOUD). Therefore, we sought to understand preferred characteristics of substance use disorder treatment centers among people recovering from OUD with a history of MOUD utilization. We recruited 30 individuals from eight states through snowball sampling initiated at three syringe exchange programs. Telephone interviews were audio-recorded and transcribed in 2018–2019. Inductive thematic analysis in Dedoose software occurred iteratively with recruitment. The following were “ideal” treatment center themes: a menu of treatment options, including MOUD and nonspiritual peer support groups; an integrated system with multiple care levels (e.g., outpatient, residential); a harm reduction approach, including for goal setting and success measures; adjunctive support services (e.g., housing); and employees with recovery experience and professional education. Many preferences directly related to core principles of person-centered care and harm reduction.

Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs

“…This includes offering a continuum of co-located treatment, harm reduction, and social services that can meet individuals where they are. This would help facilitate access to life-saving services and greater socioeconomic stability [ 28 , 29 ]. This may be particularly important for individuals with multiple vulnerabilities, as well as during emergencies—such as the COVID-19 pandemic—when minimizing travel and co-locating access to multiple health and social services is key [ 30 ].…”

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

“…Furthermore, trusted and supportive relationships with OAT providers were seen as key factors for reducing participants’ risk of relapse, and in turn, potential re-incarceration. Such positive client-centred supportive care delivered by non-judgemental OAT staff has been associated with increased treatment retention and success in other studies (Andraka-Christou et al, 2020 ; Fox, Jakubowski et al, 2019 ; Jackson, 2021 ; Maina et al, 2019 ; Marchand et al, 2018 ). For instance, one US study that examined the effectiveness of a transition clinic-based primary care program for justice-involved women who were re-entering into the community identified the importance of trauma-informed care and supportive staff in treatment engagement and retention (Thomas et al, 2019 ).…”

Treatment Experiences Among People Who Use Opioids: A Social Ecological Approach

“…Few studies have specifically examined individual-level treatment preferences among people who use opioids (Andraka-Christou et al, 2021). Andraka-Christou and colleagues interviewed people with a history of OUD and MOUD treatment utilization from eight US states to learn their preferences for substance use treatment (Andraka-Christou et al, 2021).…”

“…Few studies have specifically examined individual-level treatment preferences among people who use opioids (Andraka-Christou et al, 2021). Andraka-Christou and colleagues interviewed people with a history of OUD and MOUD treatment utilization from eight US states to learn their preferences for substance use treatment (Andraka-Christou et al, 2021). Key preferences included a harm reduction approach, multiple integrated levels of care that included counseling, self-help, and peer support, and a menu of treatment services including MOUD options (Andraka-Christou et al, 2021).…”

“…Andraka-Christou and colleagues interviewed people with a history of OUD and MOUD treatment utilization from eight US states to learn their preferences for substance use treatment (Andraka-Christou et al, 2021). Key preferences included a harm reduction approach, multiple integrated levels of care that included counseling, self-help, and peer support, and a menu of treatment services including MOUD options (Andraka-Christou et al, 2021). Policies that require integration of multiple MOUD modalities and behavioral treatments within the same site could help retain and track patients’ progress even as they feel a need to switch or try alternate medications to find the solution that best works for them in their recovery.…”