nach oben

International Journal of Mental Health and Addiction

Erschienen in:

20.08.2020 | Original Article

Barriers and Facilitators of Addiction Treatment: a Qualitative Study

verfasst von: Siddharth Sarkar, Ankush Thakur, Esha Sood, Piyali Mandal

Erschienen in: International Journal of Mental Health and Addiction | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators play a role in the processes of how patients seek care. This study aimed to understand the barriers and facilitators of addiction treatment of patients reaching an addiction treatment facility in India. This qualitative interview–based study included 49 adult patients with at least alcohol or opioid dependence. Interviews were transcribed, and thematic analysis was conducted using grounded theory approach. The common barriers of treatment were treatment-related, apprehension of the treatment of the setting, travel-related problems, work commitments, and inability to get leave and not feeling the need for treatment. The common facilitators of treatment were family-related, adverse consequences due to substance use, and treatment-related. The identified barriers and facilitators of treatment can be used to make care accessible to a larger numbers of patients with substance use disorders and bridge the treatment gap.

Ambekar, A., Agrawal, A., Rao, R., Mishra, A. K., Khandelwal, S. K., & Chadda, R. K. (2019). Magnitude of substance use in India. New Delhi: Ministry of Social Justice and Empowerment, Government of India.

Appel, P. W., Ellison, A. A., Jansky, H. K., & Oldak, R. (2004). Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders. The American Journal of Drug and Alcohol Abuse, 30(1), 129–153. https://doi.org/10.1081/ADA-120029870.CrossRefPubMed

Ashtankar, H. J., & Talapalliwar, M. R. (2017). Felt need and treatment-seeking barriers among substance abusers in urban slum area in Central India. Indian Journal of Psychological Medicine, 39(4), 436–440. https://doi.org/10.4103/0253-7176.211760.CrossRefPubMedPubMedCentral

Attilia, F., Perciballi, R., Rotondo, C., Capriglione, I., Iannuzzi, S., Attilia, M. L., Vitali, M., Alessandrini, G., Scamporrino, M. C. M., & Fiore, M. (2018). Pharmacological treatment of alcohol use disorder. Scientific evidence. Rivista di Psichiatria, 53(3), 123–127.PubMed

Balarajan, Y., Selvaraj, S., & Subramanian, S. V. (2011). Health care and equity in India. The Lancet, 377(9764), 505–515. https://doi.org/10.1016/S0140-6736(10)61894-6.CrossRef

Barman, R., Mahi, R., Kumar, N., Sharma, K. C., Sidhu, B. S., Singh, D., & Mittal, N. (2011). Barriers to treatment of substance abuse in a rural population of India. Addiction, 4, 65–71.

Beardsley, K., Wish, E. D., Fitzelle, D. B., O’Grady, K., & Arria, A. M. (2003). Distance traveled to outpatient drug treatment and client retention. Journal of Substance Abuse Treatment, 25(4), 279–285. https://doi.org/10.1016/S0740-5472(03)00188-0.CrossRefPubMed

Berridge, B. J., McCann, T. V., Cheetham, A., & Lubman, D. I. (2018). Perceived barriers and enablers of help-seeking for substance use problems during adolescence. Health Promotion Practice, 19(1), 86–93. https://doi.org/10.1177/1524839917691944.CrossRefPubMed

Bobrova, N., Rhodes, T., Power, R., Alcorn, R., Neifeld, E., Krasiukov, N., Latyshevskaia, N., & Maksimova, S. (2006). Barriers to accessing drug treatment in Russia: a qualitative study among injecting drug users in two cities. Drug and Alcohol Dependence, 82(Suppl 1), S57–S63. https://doi.org/10.1016/s0376-8716(06)80010-4.CrossRefPubMed

Bojko, M. J., Mazhnaya, A., Makarenko, I., Marcus, R., Dvoriak, S., Islam, Z., & Altice, F. L. (2015). “Bureaucracy & Beliefs”: assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine. Drugs (Abingdon, England), 22(3), 255–262. https://doi.org/10.3109/09687637.2015.1016397.CrossRef

Chadda, R. K., & Deb, K. S. (2013). Indian family systems, collectivistic society and psychotherapy. Indian Journal of Psychiatry, 55(Suppl 2), S299–S309.CrossRef

Chutuape, M. A., Katz, E. C., & Stitzer, M. L. (2001). Methods for enhancing transition of substance dependent patients from inpatient to outpatient treatment. Drug and Alcohol Dependence, 61(2), 137–143. https://doi.org/10.1016/s0376-8716(00)00133-2.CrossRefPubMed

Connery, H. S., & McHugh, R. K. (2019). Pharmacological treatment of opioid use disorders. In APA handbook of psychopharmacology. (pp. 561–588). American Psychological Association.

Dalal, P. K. (2020). Changing scenario of addiction psychiatry: challenges and opportunities. Indian Journal of Psychiatry, 62, 235–241. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_346_20.CrossRefPubMedPubMedCentral

Degenhardt, L., Whiteford, H. A., Ferrari, A. J., Baxter, A. J., Charlson, F. J., Hall, W. D., Freedman, G., Burstein, R., Johns, N., & Engell, R. E. (2013). Global burden of disease attributable to illicit drug use and dependence: findings from the global burden of disease study 2010. The Lancet, 382(9904), 1564–1574.CrossRef

Eyer, F., Schuster, T., Felgenhauer, N., Pfab, R., Strubel, T., Saugel, B., & Zilker, T. (2011). Risk assessment of moderate to severe alcohol withdrawal—predictors for seizures and delirium tremens in the course of withdrawal. Alcohol and Alcoholism, 46(4), 427–433.CrossRef

Farhadian, M., Akbarfahimi, M., Abharian, P. H., Hosseini, S. G., & Shokri, S. (2017). Assessment of executive functions in methamphetamine-addicted individuals: Emphasis on duration of addiction and abstinence. Basic and Clinical Neuroscience, 8(2), 147.CrossRef

Gautham, M. S., Gururaj, G., Varghese, M., Benegal, V., Rao, G. N., Kokane, A., Chavan, B. S., Dalal, P. K., Ram, D., Pathak, K., Lenin Singh, R. K., Singh, L. K., Sharma, P., Saha, P. K., Ramasubramanian, C., Mehta, R. Y., Shibukumar, T. M., & NMHS Collaborators Group. (2020). The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity. The International Journal of Social Psychiatry, 66, 361–372. https://doi.org/10.1177/0020764020907941.

GHO | By category | Human resources—data by country. (2020). WHO; World Health Organization. Retrieved August 9, 2020, from https://apps.who.int/gho/data/node.main.MHHR?lang=en

Gorelick, D. (2016). Pharmacological treatment of cannabis-related disorders: a narrative review. Current Pharmaceutical Design, 22(42), 6409–6419.CrossRef

Gueta, K. (2017). A qualitative study of barriers and facilitators in treating drug use among Israeli mothers: An intersectional perspective. Social Science & Medicine (1982), 187, 155–163. https://doi.org/10.1016/j.socscimed.2017.06.031.CrossRef

Jesse, S., Bråthen, G., Ferrara, M., Keindl, M., Ben-Menachem, E., Tanasescu, R., Brodtkorb, E., Hillbom, M., Leone, M. A., & Ludolph, A. C. (2017). Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurologica Scandinavica, 135(1), 4–16. https://doi.org/10.1111/ane.12671.CrossRefPubMed

Kabore, A., Afriyie-Gyawu, E., Walker, A., Hester, M., & Hansen, A. (2016). Barriers and facilitators of substance abuse treatment in Ghana (West Africa): a social-ecological perspective using Photovoice. American Public Health Association Annual Meeting (APHA). https://digitalcommons.georgiasouthern.edu/bee-facpres/15. Accessed 8 Aug 2020.

Kar, S. K., Sharma, E., Agarwal, V., Singh, S. K., Dalal, P. K., Singh, A., Gopalkrishna, G., & Rao, G. N. (2018). Prevalence and pattern of mental illnesses in Uttar Pradesh, India: findings from the National Mental Health Survey 2015–16. Asian Journal of Psychiatry, 38, 45–52.CrossRef

Khampang, R., Assanangkornchai, S., & Teerawattananon, Y. (2015). Perceived barriers to utilise methadone maintenance therapy among male injection drug users in rural areas of southern Thailand. Drug and Alcohol Review, 34(6), 645–653. https://doi.org/10.1111/dar.12268.CrossRefPubMed

Kohn, R., Ali, A. A., Puac-Polanco, V., Figueroa, C., López-Soto, V., Morgan, K., Saldivia, S., & Vicente, B. (2018). Mental health in the Americas: an overview of the treatment gap. Revista Panamericana De Salud Publica = Pan American Journal of Public Health, 42, e165. https://doi.org/10.26633/RPSP.2018.165.CrossRefPubMedPubMedCentral

Mackey, K., Veazie, S., Anderson, J., Bourne, D., & Peterson, K. (2019). Evidence brief: barriers and facilitators to use of medications for opioid use disorder. Department of Veterans Affairs (US). http://www.ncbi.nlm.nih.gov/books/NBK549203/. Accessed 8 Aug 2020.

Mattoo, S. K., Singh, S. M., & Sarkar, S. (2015). De-addiction Services in India. In Developments in Psychiatry in India (pp. 405–416). New Delhi: Springer.

Mellinger, J. L., Scott Winder, G., DeJonckheere, M., Fontana, R. J., Volk, M. L., Lok, A. S. F., & Blow, F. C. (2018). Misconceptions, preferences and barriers to alcohol use disorder treatment in alcohol-related cirrhosis. Journal of Substance Abuse Treatment, 91, 20–27. https://doi.org/10.1016/j.jsat.2018.05.003.CrossRefPubMed

Nebhinani, N., Sarkar, S., Ghai, S., & Basu, D. (2012). Reasons for help-seeking and associated fears in subjects with substance dependence. Indian Journal of Psychological Medicine, 34(2), 153–158.CrossRef

Owens, M. D., Chen, J. A., Simpson, T. L., Timko, C., & Williams, E. C. (2018). Barriers to addiction treatment among formerly incarcerated adults with substance use disorders. Addiction Science & Clinical Practice, 13(1), 19. https://doi.org/10.1186/s13722-018-0120-6.CrossRef

Patel, P., Kaiser, B. N., Meade, C. S., Giusto, A., Ayuku, D., & Puffer, E. (2020). Problematic alcohol use among fathers in Kenya: Poverty, people, and practices as barriers and facilitators to help acceptance. The International Journal on Drug Policy, 75, 102576. https://doi.org/10.1016/j.drugpo.2019.10.003.CrossRefPubMed

Peacock, A., Leung, J., Larney, S., Colledge, S., Hickman, M., Rehm, J., et al. (2018). Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction, 113(10), 1905–1926. https://doi.org/10.1111/add.14234.CrossRefPubMed

Perumbilly, S. A., Melendez-Rhodes, T., & Anderson, S. A. (2019). Facilitators and barriers in treatment seeking for substance use disorders: Indian clinical perspectives. Alcoholism Treatment Quarterly, 37(2), 240–256. https://doi.org/10.1080/07347324.2018.1530579.CrossRef

Rao, R. (2017). The journey of opioid substitution therapy in India: achievements and challenges. Indian Journal of Psychiatry, 59(1), 39–45.CrossRef

Rapp, R. C., Xu, J., Carr, C. A., Lane, D. T., Wang, J., & Carlson, R. (2006). Treatment barriers identified by substance abusers assessed at a centralized intake unit. Journal of Substance Abuse Treatment, 30(3), 227–235. https://doi.org/10.1016/j.jsat.2006.01.002.CrossRefPubMedPubMedCentral

Rathod, S., Pinninti, N., Irfan, M., Gorczynski, P., Rathod, P., Gega, L., & Naeem, F. (2017). Mental health service provision in low- and middle-income countries. Health Services Insights, 10, 1178632917694350. https://doi.org/10.1177/1178632917694350.CrossRefPubMedPubMedCentral

Redko, C., Rapp, R. C., & Carlson, R. G. (2006). Waiting time as a barrier to treatment entry: perceptions of substance users. Journal of Drug Issues, 36(4), 831–852. https://doi.org/10.1177/002204260603600404.CrossRefPubMedPubMedCentral

Rehm, J., Taylor, B., & Room, R. (2006). Global burden of disease from alcohol, illicit drugs and tobacco. Drug and Alcohol Review, 25(6), 503–513. https://doi.org/10.1080/09595230600944453.CrossRefPubMed

Russell, C., Neufeld, M., Sabioni, P., Varatharajan, T., Ali, F., Miles, S., Henderson, J., Fischer, B., & Rehm, J. (2019). Assessing service and treatment needs and barriers of youth who use illicit and non-medical prescription drugs in Northern Ontario, Canada. PloS One, 14(12), e0225548. https://doi.org/10.1371/journal.pone.0225548.CrossRefPubMedPubMedCentral

Sarkar, S., Patra, B. N., & Kattimani, S. (2016). Substance use disorder and the family: an Indian perspective. Medical Journal of Dr. D.Y. Patil University, 9(1), 7–14. https://doi.org/10.4103/0975-2870.172413.CrossRef

Stöver, H. (2011). Barriers to opioid substitution treatment access, entry and retention: a survey of opioid users, patients in treatment, and treating and non-treating physicians. European Addiction Research, 17(1), 44–54. https://doi.org/10.1159/000320576.CrossRefPubMed

Strauss, A., & Corbin, J. M. (1990). Basics of qualitative research: grounded theory procedures and techniques. Sage Publications, Inc.

Timko, C., Schultz, N. R., Britt, J., & Cucciare, M. A. (2016). Transitioning from detoxification to substance use disorder treatment: facilitators and barriers. Journal of Substance Abuse Treatment, 70, 64–72. https://doi.org/10.1016/j.jsat.2016.07.010.CrossRefPubMedPubMedCentral

Tucker, J. A., Vuchinich, R. E., & Rippens, P. D. (2004). A factor analytic study of influences on patterns of help-seeking among treated and untreated alcohol dependent persons. Journal of Substance Abuse Treatment, 26(3), 237–242. https://doi.org/10.1016/S0740-5472(03)00209-5.CrossRefPubMed

Verissimo, A. D., & Grella, C. E. (2017). Influence of gender and race/ethnicity on perceived barriers to help-seeking for alcohol or drug problems. Journal of Substance Abuse Treatment, 75, 54–61. https://doi.org/10.1016/j.jsat.2016.12.013.CrossRefPubMedPubMedCentral

Wieczorek, Ł. (2017). Barriers in the access to alcohol treatment in outpatient clinics in urban and rural community. Psychiatria Polska, 51(1), 125–138. https://doi.org/10.12740/PP/60345.CrossRefPubMed

World health organization. (2018). World drug report 2018. United Nations publication.

Wu, F., Peng, C.-Y., Jiang, H., Zhang, R., Zhao, M., Li, J., & Hser, Y.-I. (2013). Methadone maintenance treatment in China: perceived challenges from the perspectives of service providers and patients. Journal of Public Health (Oxford, England), 35(2), 206–212. https://doi.org/10.1093/pubmed/fds079.CrossRef

Yang, Y., Perkins, D. R., & Stearns, A. E. (2018). Barriers and facilitators to treatment engagement among clients in inpatient substance abuse treatment. Qualitative Health Research, 28(9), 1474–1485. https://doi.org/10.1177/1049732318771005.CrossRefPubMed

Yip, W., & Mahal, A. (2008). The health care systems of China and India: performance and future challenges. Health Affairs, 27(4), 921–932. https://doi.org/10.1377/hlthaff.27.4.921.CrossRefPubMed

Zelenev, A., Shea, P., Mazhnaya, A., Rozanova, J., Madden, L., Marcus, R., & Altice, F. L. (2018). Assessment of barrier severity and willingness to enter opioid agonist treatment among people who inject drugs in Ukraine. Drug and Alcohol Dependence, 190, 82–88. https://doi.org/10.1016/j.drugalcdep.2018.05.027.CrossRefPubMedPubMedCentral

Zhou, K., Li, H., Wei, X., Li, X., & Zhuang, G. (2017). Medication adherence in patients undergoing methadone maintenance treatment in Xi’an, China. Journal of Addiction Medicine, 11(1), 28–33. https://doi.org/10.1097/ADM.0000000000000263.CrossRefPubMed

Titel: Barriers and Facilitators of Addiction Treatment: a Qualitative Study
verfasst von: Siddharth Sarkar
Ankush Thakur
Esha Sood
Piyali Mandal
Publikationsdatum: 20.08.2020
Verlag: Springer US
Erschienen in: International Journal of Mental Health and Addiction / Ausgabe 2/2022
Print ISSN: 1557-1874
Elektronische ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-020-00394-x

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2022

Size Estimation of People Who Inject Drugs and Their Geographical Distribution in Dogonbadan, Iran, During 2018: a Mapping Method

The Development of the Internalization of Sociocultural Body Ideals Scale Using Items From the Sociocultural Attitudes Towards Appearance Questionnaire: Validity, Reliability, and Measurement Invariance Testing

Nurses’ Sleep Quality of “Fangcang” Hospital in China during the COVID-19 Pandemic

Land-Based Healing: Toward Understanding the Role of Elders