A preliminary comparison of major kinds of obstacles to enrolling in substance abuse treatment (AOD) reported by injecting street outreach clients and other stakeholders.
Injecting drug users (IDU) (n=144), street outreach (n=55), and treatment program (n=71) staff and managers in stakeholder government agencies (n=11) cited or mentioned many barriers to enrolling in substance abuse treatment (AOD), using varied assessment instruments (1). Here, we aimed to investigate a possible overemphasis on individual client factors (e.g., "readiness," denial) as barriers to enrollment and the relative importance of other kinds of barriers, e.g., limitations using a four-category classification of: individual client factors (IC), treatment accessibility (TAX), treatment availability (AVL), and (lack of) client acceptability (CA), reflecting stigmatization of IDUs. TAX responses predominated for outreach staff (51%), government managers (39%), and barriers implied by client suggestions (52%). IC (60%) followed by TAX (36%) factors characterized barriers clients generated directly. The IC factor thus appears overrepresented among IDUs and TAX is important for all groups suggesting a greater focus on access may be more cost-effective than on individual treatment motivation interventions.
Appel
Philip W
PW
New York State Office of Alcoholism and Substance Abuse Services, New York, New York 10018-5903, USA. appelp@oasas.state.ny.us
Oldak
Rivka
R
D003156:Community Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000706:statistics & numerical data*; D006556:Heroin Dependence / Q000523:psychology / Q000628:therapy*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D012949:Social Work, Psychiatric / Q000458:organization & administration; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000523:psychology* / Q000628:therapy*
D013287:Illicit Drugs