scholarly journals A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cayley Russell ◽  
Farihah Ali ◽  
Frishta Nafeh ◽  
Sean LeBlanc ◽  
Sameer Imtiaz ◽  
...  
Keyword(s):  
Substance Use ◽  
Service Provision ◽  
Program Planning ◽  
Scale Up ◽  
People Who Use Drugs ◽  
Service Access ◽  
Service Needs ◽  
Treatment Needs ◽  
Polysubstance Use ◽  
Substance Use Services

Abstract Background People who use drugs (PWUD) often have complex health and social support needs related to substance use, yet face numerous barriers to service access, resulting in unmet treatment needs and a corresponding gap in treatment. While initiatives to scale up substance use services for PWUD in Canada - and Ontario - have been undertaken, these have excluded PWUD’ perspectives, and their needs have largely been defined by other actors. As end-users of services, PWUD’ perspectives are vital to understanding what services are required, and whether existent services are adequate, appropriate and effective. Thus, the present study aimed to elicit in-depth knowledge from PWUD with lived experience of accessing services to better understand their unmet treatment and service needs, towards closing the service and treatment gap in Ontario. Methods This qualitative study included one-on-one interviews conducted with a cohort of n = 45 adult PWUD with substance use and treatment experience in Ontario, Canada. Participants were recruited from substance use services based on ConnexOntario’s directory of all provincial addiction services, as well as by word-of-mouth. Questions focused on participants’ experiences and perspectives on substance use services towards understanding their service needs. Data underwent an inductive thematic analysis based on key themes that emerged. Results Participants commonly engaged in polysubstance use, and identified a number of unmet substance use service needs including complex factors within the current service system that influenced access to available programs. Specifically, participants suggested the need to address stigmatization and system fragmentation, increase service provision and capacity, and scale up specific services and related supports such as harm reduction, counseling, treatment, and housing. Conclusions This study identified PWUD’ needs in relation to substance use service provision in Ontario, Canada, and highlighted important areas for policy change and program planning and implementation. Concrete recommendations include the development of a government-funded, low-barrier, comprehensive and integrated service delivery and referral models that include PWUD as collaborators and program facilitators to ensure that services are as accessible, effective, and cohesive as possible. Results from this study can be used to enhance provincial substance use treatment and service provision.

scholarly journals Examining Substance Use Services and Treatment Barriers and Needs among People with Lived Experience (PWLE) in Ontario, Canada.

2020 ◽  
Author(s):  
Cayley Russell ◽  
Farihah Ali ◽  
Frishta Nafeh ◽  
Sean LeBlanc ◽  
Sameer Imtiaz ◽  
...  
Keyword(s):  
Substance Use ◽  
Lived Experience ◽  
Treatment Options ◽  
Program Planning ◽  
System Level ◽  
Service Access ◽  
Service Needs ◽  
Problematic Substance ◽  
Substance Use Services ◽  
Barriers To Service

Abstract Introduction: Substance use is a complex issue, with rates of illicit and licit substances varying across Canada, and in Ontario, specifically. Services and treatment options for problematic substance use remain vital. Recent initiatives to increase the effectiveness of services have been implemented, however, a disconnect remains between the availability and accessibility of these programs and the real-world experiences and needs of people with lived experience (PWLE). There is a lack of knowledge regarding barriers to accessing services and service needs, yet PWLE are best suited to identify these factors. As such, this study critically examined these issues among a cohort of PWLE in Ontario, Canada. Methods: Semi-structured, one-on-one interviews with n=50 adult PWLE participants were conducted. Participants were recruited from substance use services across Ontario, based on ConnexOntario’s directory of all provincial addiction services, as well as by word-of-mouth. Questions focused on participants’ experiences and perspectives on substance use services. All data were transcribed and underwent an inductive thematic analysis based on key themes that emerged. Results: Beneficial services identified varied based on participant experiences and needs. A variety of barriers to service access were acknowledged, primarily related to system-level issues such as an overall lack of services, a lack of service capacity, and a severe lack of service coordination and gaps in service delivery. Recommendations revolved around the need for low-barrier, affordable, seamless services run by non-judgemental staff, including fellow PWLE. Conclusions: This study identified needs and barriers to substance use care among PWLE in Ontario, and highlighted important areas for policy change and program planning and implementation. Concrete recommendations include the development of a government-funded, low-barrier, comprehensive and integrated model of substance use services that includes PWLE as collaborators and program facilitators to ensure that services are as successful and meaningful as possible. Results from this study will work towards the improvement of substance use treatment and service provision across the province.

Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

2020 ◽  
Author(s):  
MariaGabriela Uribe Guajardo ◽  
Andrew James Baillie ◽  
Eva Louie ◽  
Vicki Giannopoulos ◽  
Katie Wood ◽  
...  
Keyword(s):  
Substance Use ◽  
Clinical Supervision ◽  
Mental Health Problems ◽  
Scale Up ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Self Report ◽  
Evidence Based ◽  
Face To Face ◽  
Drug And Alcohol

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

scholarly journals Going virtual: youth attitudes toward and experiences of virtual mental health and substance use services during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa D. Hawke ◽  
Natasha Y. Sheikhan ◽  
Karen MacCon ◽  
Joanna Henderson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Youth Mental Health ◽  
Research Process ◽  
Clinical Samples ◽  
Future Research ◽  
Advantages And Disadvantages ◽  
Substance Use Services ◽  
Youth Attitudes ◽  
Virtual Services

Abstract Background During the COVID-19 pandemic, youth mental health and substance use services rapidly moved to virtual modalities to meet social distancing requirements. It is important to understand youth attitudes toward and experience of virtual services. Objective This study examined the attitudes toward and experiences of virtual mental health and substance use services among youth drawn from clinical and non-clinical samples. Method Four hundred nine youth completed a survey including questions about their attitudes toward and experience of virtual services. The survey included quantitative and open-ended questions on virtual care, as well as a mental health and substance use screener. Results The majority of youth with mental health or substance use challenges would be willing to consider individual virtual services, but fewer would consider group virtual services. However, many have not received virtual services. Youth are interested in accessing a wide variety of virtual services and other supportive wellness services. Advantages and disadvantages of virtual services are discussed, including accessibility benefits and technological barriers. Discussion As youth mental health and substance use services have rapidly gone virtual during the COVID-19 pandemic, it is essential that we hear the perspectives of youth to promote service utilization among those in need. Diverse, accessible, technologically stable virtual services are required to meet the needs of different youth, possibly with in-person options for some youth. Future research, engaging youth in the research process, is needed to evaluate the efficacy of virtual services to plan for the sustainability of some virtual service gains beyond the pandemic period.

Meeting the Treatment Needs of Veterans with Substance Use Disorders

2016 ◽  
Vol 34 (3) ◽  
pp. 354-364 ◽  
Author(s):  
Jerome F. X. Carroll ◽  
Charles E. Hall ◽  
Roy Kearse ◽  
Michael Mooney ◽  
Jo Potestivo ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Treatment Needs

scholarly journals Identifying the impacts of the COVID-19 pandemic on service access for people who use drugs (PWUD): A national qualitative study

2021 ◽  
Vol 129 ◽  
pp. 108374
Author(s):  
Cayley Russell ◽  
Farihah Ali ◽  
Frishta Nafeh ◽  
Jürgen Rehm ◽  
Sean LeBlanc ◽  
...  
Keyword(s):  
Qualitative Study ◽  
People Who Use Drugs ◽  
Service Access

scholarly journals Treatment Needs of Men and Women with Violence Problems In Substance Use Disorder Treatment

2009 ◽  
Vol 44 (9-10) ◽  
pp. 1236-1262 ◽  
Author(s):  
Stephen T. Chermack ◽  
Regan L. Murray ◽  
Jamie J. Winters ◽  
Maureen A. Walton ◽  
Brenda M. Booth ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Treatment Needs ◽  
Substance Use Disorder Treatment ◽  
Men And Women ◽  
Disorder Treatment

scholarly journals Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. J. Fredericksen ◽  
B. M. Whitney ◽  
E. Trejo ◽  
R. M. Nance ◽  
E. Fitzsimmons ◽  
...  
Keyword(s):  
Substance Use ◽  
Fixed Effects ◽  
Hiv Status ◽  
Anal Sex ◽  
Condomless Sex ◽  
Polysubstance Use ◽  
Vaginal Sex ◽  
Heterosexual Sex ◽  
The Impact ◽  
Hiv Negative

Abstract Background We analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS. Methods We analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years). Results For both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8–16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18–21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9–10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5–8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7–8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9–13%, p ≤ 0.03). Conclusion Except for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.

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