title: Perceptions of methadone maintained clients about barriers and facilitators to help-seeking behavior.
abstract: BACKGROUND
  Among substance users, health seeking remains a major challenge for which few data are available.
  
  
  OBJECTIVE
  We sought to investigate the perceptions of methadone-maintained heroin users who are also problem or heavy drinkers, their barriers and facilitators to seeking help for substance and general and chronic care treatment.
  
  
  METHODS
  A qualitative design using a semistructured focus group approach was conducted with a convenience sample of 41 adult clients of a methadone maintenance facility in Los Angeles.
  
  
  RESULTS
  Findings revealed that discrimination was a major challenge experienced as a result of their methadone status. Lack of primary care providers, limited access to health care facilities and access barriers were pervasive. Focus group participants expressed a desire for nonjudgemental and empathetic care that would foster respect and facilitate help-seeking behaviors through a comprehensive support system.
  
  
  CONCLUSIONS
  The need to design culturally relevant training programs was evident which included an integration of treatment, communication and societal issues.
authors.affiliation: School of Nursing, University of California, Los Angeles, USA.
authors.forename: Adeline
authors.initials: A
authors.lastname: Nyamathi
authors.forename: Donna McNeese
authors.initials: DM
authors.lastname: Smith
authors.forename: Steven
authors.initials: S
authors.lastname: Shoptaw
authors.forename: Malaika
authors.initials: M
authors.lastname: Mutere
authors.forename: Allan
authors.initials: A
authors.lastname: Cohen
authors.forename: Israel
authors.initials: I
authors.lastname: Amrani
authors.forename: Louis
authors.initials: L
authors.lastname: Morales
authors.forename: Viviane
authors.initials: V
authors.lastname: de Castro
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000628:therapy; D001291:Attitude of Health Personnel; D055030:Drug Users; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D015141:Los Angeles; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D011287:Prejudice; D011369:Professional-Patient Relations; D016320:Substance Abuse Treatment Centers / Q000592:standards; D055815:Young Adult
chemical_list: D009294:Narcotics; D008691:Methadone