title: Harlem service providers' perceptions of the impact of municipal policies on their clients with substance use problems.
abstract: Substance abuse is a significant health and social problem in many low-income urban communities. Finding appropriate help for drug users has been identified as a significant barrier to reducing the harm from drug abuse. This report presents findings from a survey of service providers in the Central and East Harlem communities, New York City, conducted in 2000 to identify policy obstacles that impeded clients' attempts to overcome substance use and related problems. Policies can affect substance users by making access to drug treatment more difficult or by imposing unrealistic expectations on substance users for eligibility for benefit programs. Respondents to the survey were asked to rate 30 specific policies as harmful or helpful to their clients and to assess how the policies acted as barriers or facilitators to getting services and reducing drug use. Eleven policies in the areas of drug treatment, corrections, and Medicaid were rated as harmful to their clients by more than 50% of the respondents. We discuss the implications of these and other findings for drug users' ability to seek and receive help for their problems.
authors.affiliation: San Francisco State University, Department of Health Education, CA 94132, USA. jvo@sfsu.edu
authors.forename: Juliana
authors.initials: J
authors.lastname: van Olphen
authors.forename: Nicholas
authors.initials: N
authors.lastname: Freudenberg
mesh_terms: D000328:Adult; D002648:Child; D002669:Child Welfare; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006297:Health Services Accessibility; D006798:Housing; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009519:New York City; D016495:Police; D011329:Prisoners; D012947:Social Work; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D019037:Urban Health Services / Q000458:organization & administration*; D014505:Urban Population