Systemic and individual factors in the buprenorphine treatment-seeking process: a qualitative study
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RESEARCH
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Systemic and individual factors in the buprenorphine treatment-seeking process: a qualitative study Valerie M. Hewell*, Angel R. Vasquez and Inna D. Rivkin
Abstract Background: Opioid use is a significant problem in Alaska. Medication-assisted treatment for opioid use, including buprenorphine, reduces withdrawal symptoms and the harm associated with opioid abuse. Understanding consumers’ treatment-seeking process is important for addressing barriers to treatment, facilitating effective service utilization, and informing policy. Methods: To understand treatment-seeking behavior, we examined the attitudes, perceptions, and knowledge of those who would benefit from the medication-assisted treatment (MAT) buprenorphine. Qualitative data from 2 focus groups (each including 4 participants) and 3 in-depth interviews with people who have used or considered using buprenorphine in treatment for an opioid use disorder were analyzed using grounded theory and directed content analysis approaches. Results: Key findings suggest that individual (withdrawal process, individual motivation) and systemic (sociocultural, political, societal values) factors frame the treatment seeking process. Participants’ progress on the treatmentseeking road was affected by models of addiction and MAT, which related to facilitators and barriers encountered in seeking treatment (e.g. support, resources, treatment structure). These factors shaped the longer-term road to recovery, which was seen as on ongoing process. Conclusions: The findings of this study suggest it is crucial for interventionists to take a contextual approach that considers individual and systemic factors involved in opioid addiction, treatment, and recovery. This study highlights ways policy makers and treatment providers can address the barriers consumers face in their treatmentseeking process in order to increase treatment access. Keywords: Medication-assisted treatment, Qualitative research, Opioid use, Treatment-seeking, Policy
Background Opioid use disorder involves continued misuse of opioids despite recurrent problems occurring from use [1]. Due to the sizable incidences of nonmedical prescription opioid initiation [2] and the harm associated with opioid use including rising rates of overdose [3], there is alleged to be a national opioid epidemic in the United States [3–5]. Opioid misuse is also a noteworthy problem in the state of Alaska, which consistently ranks in the top ten states of the nation for illicit drug dependence [6]. Moreover, fatal drug overdose rates, the majority of * Correspondence: [email protected] Department of Psychology, University of Alaska Fairbanks, P.O. Box 756480AK 99775 Fairbanks, USA
which include prescription drugs, increased by 55% between 1999 and 2010 in Alaska [7]. Particularly, in Alaska, the unmet treatment needs of citizens with drug dependence have consistently registered above the national average [6]. Moreover, disparities have been found in the services patients with co-occurring disorders receive,
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