Exploring the psychological benefits and challenges experienced by peer-helpers participating in take-home naloxone programmes: A rapid review

Marshall, Carley; Piat, Myra; Perreault, Michel

doi:10.1080/09687637.2016.1269724

Cited by 12 publications

(7 citation statements)

References 60 publications

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“…Peer-based service work is valued due to peer workers’ ability to build relationships and trust, challenge power hierarchies, and increase the relevance of programs and services [ 18 ]. Benefits to service workers themselves include a sense of inclusion, connection, empowerment, and agency [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Organizational support for frontline harm reduction and systems navigation work among workers with living and lived experience: qualitative findings from British Columbia, Canada

et al. 2021

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Background The inclusion of people with lived and living experience of substance use is essential to effective and client-centered harm reduction services and strategies. The aim of this study is to critically examine and characterize peer worker roles and the definition, recognition, and support for these roles within harm reduction organizations. Methods Fifteen interviews were conducted with peer workers—people with lived and living experience of substance use engaged in harm reduction service delivery—in British Columbia, Canada. An interpretive descriptive approach to data analysis was used to generate themes that best illustrated the roles of peer workers. Findings Two interrelated and overarching themes are presented: (1) peer work in practice; (2) organizational support. Our findings illustrate that peer work is incredibly complex and demanding, requiring peers to be at the forefront of support within their communities while simultaneously navigating the oppressive structures within which they work. While peer workers found a high degree of purpose and meaning in their day-to-day work, their roles lacked definition within organizations, which produced feelings of ineffectiveness and being undervalued. A lack of organizational understanding and recognition of their roles was evident from unclear "peer" role titles, a lack of role communication and expectations, the representation of experiential knowledge, and a lack of role support and training. Conclusions These findings may help harm reduction organizations understand peer work and worker roles which may inform and promote equity in future harm reduction initiatives that include people with living and lived experience of substance use.

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Section: Introductionmentioning

confidence: 99%

Organizational support for frontline harm reduction and systems navigation work among workers with living and lived experience: qualitative findings from British Columbia, Canada

et al. 2021

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“…Finally, formalized peer roles not only boost self-efficacy, but have also been shown to improve self-esteem and a sense of community that could potentially reduce alienation, marginalization, and the stigmatization of PWUD. 62 Consistent with the benefits and limitations of peerrun programs (e.g., overburdening PWUD) highlighted earlier, concerns have been raised about labor issues that sometimes arise in peer-run programs. These are related to inconsistent work schedules and wages that do not meet poverty-level standards.…”

Section: Next Steps: a Community-based Responsementioning

confidence: 87%

The Opioid Epidemic: Task-Shifting in Health Care and the Case for Access to Harm Reduction for People Who Use Drugs

Jozaghi

2020

Int J Health Serv

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We are sadly experiencing unprecedented levels of overdose mortalities attributed to the increased availability of synthetic opioids in illegal markets. While the majority of attention in North America has focused on preventing drug overdose cases through the distribution and administration of naloxone, in addition to stricter regulations of opioid prescriptions and greater law enforcement in illegal markets, little attention has been given to other alternative models and treatments for people who use drugs that are tailored specifically to the health care needs of this marginalized population. Through this analysis, the implications of task-shifting in health care via the distribution of naloxone for an already marginalized population are discussed. Alternatively, the role of pioneering harm-reduction programs – such as supervised injection/consumption sites, a variety of opioids maintenance therapies, and social-structural interventions – are highlighted as crucial interventions in the current ongoing opioid crisis. Moreover, people with lived experiences of illegal drug use are discussed as having a pivotal role but being ultimately overshadowed by public health partners.

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“…With limited linkage services provided by the methadone treatment clinic, long waiting times and lack of material and social capital resources necessary to navigate care hampered patients' ability to access these services. To foster support for these patients, implementing inexpensive interventions such as peer recovery support services that have been effective in linking patients to required services is needed [ 31 , 36 , 37 ]. Peer-based interventions can include multiple dimensions of support such as mentorship and education, from those who have lived experiences using substances [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Peer-based interventions can include multiple dimensions of support such as mentorship and education, from those who have lived experiences using substances [ 36 ]. Peer-based interventions can also provide much-needed support and encouragement to empower patients to take responsibility for their recovery [ 31 , 35 – 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…People on MOUD hypothesize that peer-based interventions would play a positive role in their care—from outreach to promote programs to assisting with navigating treatment expectations [ 31 ]. In these environments, implementing peer recovery intervention values lived experiential knowledge, can help decrease substance use, and increase treatment adherence [ 36 , 37 ]. For example, Bernstein [ 38 ], found that when participants had a brief motivational telephone call with someone with lived substance use experience, they were more likely to be abstinent from cocaine and heroin after a six-month period.…”

Section: Discussionmentioning

confidence: 99%

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Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

Marshall

Maina

Sherstobitoff

2021

Addict Sci Clin Pract

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Background Patients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment—which requires patient compliance with many rules of care—often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes. Methods In this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower’s PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients. Results We present how PCC's concepts of; (a) biopsychosocial perspective; (b) patient as a person; (c) sharing power and responsibility; (d) therapeutic alliance and (e) doctor as a person—are applied in a methadone treatment program. We identified both opportunities and barriers to providing PCC in these settings. Conclusion In a highly restrictive methadone treatment program, full implementation of PCC is not possible. However, implementation of some aspects of PCC are possible to improve patient empowerment and engagement with care, possibly leading to increase in retention and better treatment outcomes.

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Exploring the psychological benefits and challenges experienced by peer-helpers participating in take-home naloxone programmes: A rapid review

Cited by 12 publications

References 60 publications

Organizational support for frontline harm reduction and systems navigation work among workers with living and lived experience: qualitative findings from British Columbia, Canada

Organizational support for frontline harm reduction and systems navigation work among workers with living and lived experience: qualitative findings from British Columbia, Canada

The Opioid Epidemic: Task-Shifting in Health Care and the Case for Access to Harm Reduction for People Who Use Drugs

Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

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