“The Rock Always Comes First”: Drug Users' Accounts About Using Formal Health Care

Abstract

Illicit drug use remains a significant public health threat. The issues surrounding drug use are recognized by public health professionals as important for several reasons. The incidence and prevalence of drug use persists in spite of the extensive societal, interpersonal, and individual consequences. In addition, the chronic health issues and health care costs associated with drug use continue to spiral. A wide variety of quantitative studies have examined the extent of health care problems, access, cost, and health care satisfaction among illicit drug users. While these studies offer important information through survey formats, fewer studies focus on subjective constructions of health care management from the users' perspective. This article examines the elements of the decision-making process involved in accessing formal health care among chronic and injecting street drug users. Twenty-eight in-depth interviews provide the data for this analysis, which is part of a large quantitative study of 1,479 injecting and chronic drug users and nondrug users in Miami, Florida. By exploring the elements of health care access through the eyes of the drug users, researchers and treatment professionals may gain insights into new ways to improve health care access for this at-risk population.

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

“…mental health, cancer, asthma research, increasing attention is given to clients' perspectives about the treatment they have received and about their life in general. Drug users have not been seen as important sources of information in substance abuse research-rather as passive individuals-and their perspective is a missing link in the literature (Brun and Rapp 2001;Drumm et al 2003;Hunt and Barker 1999). Saleebey (1996, p. 301) states that it may be one of the typical characteristics of oppressed or marginalized populations to have ''one's stories buried under the forces of ignorance and stereotype''.…”

Comparison of Single and Multiple Agency Clients in Substance Abuse Treatment Services

“…These issues should be further explored through in-depth, qualitative interviews with multiple agency attendees about their treatment needs and argumentation for addressing various agencies within a short period of time. Up to now, available research has predominantly focused on issues related to treatment access and participation and client satisfaction [55] , but to a lesser extent on patterns of treatment utilization and underlying motives for it [56,57] . Finally, it is recommended to also assess the characteristics of organizations and treatment systems, e.g.…”

Treatment satisfaction and quality of support in outpatient substitution treatment: opiate users’ experiences and perspectives

“…Drug users are seldom seen as important sources of information and their personal perspectives about substance abuse treatment and life in general are not widely reported in the literature (Drumm et al, 2003;Fischer, Rehm, & Kim, 2001;Kolind, 2007;Montagne, 2002), even though such studies may present an alternative perspective on these issues (Brun & Rapp, 2001;Vanderplasschen & De Maeyer, 2007). Yet, information on the impact of health problems and their treatment on the daily life of individuals' suffering from chronic illnesses is often more revealing than objective outcome indicators regarding individuals' functioning or clinical recovery (Wiklund, 2004).…”