Friday, March 4, 2016

Factors Associated with Inability to Access Addiction Treatment among People Who Inject Drugs in Vancouver, Canada

BACKGROUND:
Addiction treatment is an effective strategy used to reduce drug-related harm. In the wake of recent developments in novel addiction treatment modalities, we conducted a longitudinal data analysis to examine factors associated with inability to access addiction treatment among a prospective cohort of persons who inject drugs (PWID).

METHODS:
Data were derived from two prospective cohorts of PWID in Vancouver, Canada, between December 2005 and November 2013. Using multivariate generalized estimating equations, we examined factors associated with reporting an inability to access addiction treatment.

RESULTS:
In total, 1142 PWID who had not accessed any addiction treatment during the six months prior to interview were eligible for this study, including 364 women (31.9 %). Overall, 188 (16.5 %) reported having sought but were ultimately unsuccessful in accessing addiction treatment at least once during the study period. In multivariate analysis, factors independently and positively associated with reporting inability to access addiction treatment included: binge drug use (Adjusted Odds Ratio [AOR] = 1.65), being a victim of violence (AOR = 1.77), homelessness (AOR = 1.99), and having ever accessed addiction treatment (AOR = 2.33); while length of time injecting was negatively and independently associated (AOR = 0.98) (all p < 0.05).

CONCLUSIONS:
These findings suggest that sub-populations of PWID were more likely to report experiencing difficulty accessing addiction treatment, including those who may be entrenched in severe drug addiction and vulnerable to violence. It is imperative that additional resources go into ensuring treatment options are readily available when requested for these target populations.

Reasons for being unable to access addition treatment among PWID in Vancouver, Canada (n = 250)
ReasonsNumber of reports% of reports
Waiting list14658.4
Don’t take couples208.0
Turned down by program197.6
Personal reasons/issues135.2
Communication issues with the program114.4
Behaviour problems93.6
Missed appointments93.6
Program is full83.2
Don’t know of any program72.8
Don’t have type of program I want or need72.8
Can’t afford the fees72.8
Failed too many times20.8
No treatment program nearby10.4
Methadone restrictions within the program10.4
Other (in jail, no pets policy, medical issues, too many rules)3915.6
PWID people who inject drugs

Full article at:   http://goo.gl/7FjrLZ

By:  Prangnell A1Daly-Grafstein B2Dong H3Nolan S4,5Milloy MJ6,7Wood E8,9Kerr T10,11Hayashi K12,13.
  • 1British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. aprangnell@cfenet.ubc.ca.
  • 2Human Biology Program, University of Toronto, Wetmore Hall, Room 105, 300 Huron Street, Toronto, ON, M5S 3J6, Canada. bendgrafstein@gmail.com.
  • 3British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. hdong@cfenet.ubc.ca.
  • 4British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. seonaidn@gmail.com.
  • 5Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. seonaidn@gmail.com.
  • 6British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-mjsm@cfenet.ubc.ca.
  • 7Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-mjsm@cfenet.ubc.ca.
  • 8British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-ew@cfenet.ubc.ca.
  • 9Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-ew@cfenet.ubc.ca.
  • 10British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-tk@cfenet.ubc.ca.
  • 11Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-tk@cfenet.ubc.ca.
  • 12British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. khayashi@cfenet.ubc.ca.
  • 13Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. khayashi@cfenet.ubc.ca.
  •  2016 Feb 25;11(1):9. doi: 10.1186/s13011-016-0053-6. 



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