title: Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis.
abstract: Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified as a major public health concern. Methamphetamine treatment programmes have been effective in reducing and ceasing use, however a range of barriers have prevented these programmes being widely adopted by methamphetamine users. This review examines the barriers to accessing meth/amphetamine treatment identified in the literature.
  
  
  
  Databases were systematically searched using relevant terms for peer-reviewed articles describing original research exploring the barriers to accessing treatment for meth/amphetamine use. Reviews and grey literature were excluded. Eleven studies conducted in 5 countries were included in data synthesis; this involved a systematic review of all 11 studies, and meta-analysis of the prevalence of barriers reported in 6 studies that published sufficient quantitative data.
  
  
  
  Psychosocial/internal barriers to accessing methamphetamine treatment were most prevalent across studies (10/11 studies). Meta-analysis confirmed the four most commonly endorsed barriers to treatment access across studies all psychosocial barriers were embarrassment or stigma (60%, 95% CI: 54-67%); belief that treatment was unnecessary (59%, 95% CI:54-65%); preferring to withdraw alone without assistance (55%, 95% CI:45-65); and privacy concerns (51%, 95% CI:44-59%).
  
  
  
  The primary barriers to accessing methamphetamine treatment are psychosocial/internal. Services and treatment models that address these barriers are urgently required. There is a growing need for methamphetamine-appropriate treatment services. Further research evaluating treatment engagement and effectiveness for methamphetamine and polysubstance use, including the development of effective pharmacotherapies is warranted.
authors.affiliation: Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia. Electronic address: craig.cumming@uwa.edu.au.
authors.forename: Craig
authors.initials: C
authors.lastname: Cumming
authors.affiliation: Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
authors.forename: Lakkhina
authors.initials: L
authors.lastname: Troeung
authors.affiliation: Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie St, Carlton, Victoria 3053, Australia; National Drug Research Institute, Curtin University, Level 2, 10 Selby Street, Shenton Park, Western Australia 6008, Australia.
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Young
authors.affiliation: Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Kelty
authors.affiliation: Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
authors.forename: David B
authors.initials: DB
authors.lastname: Preen
mesh_terms: D019969:Amphetamine-Related Disorders / Q000523:psychology* / Q000628:therapy; D003469:Culture; D006801:Humans; D008694:Methamphetamine; D057545:Social Stigma; D016312:Treatment Refusal / Q000523:psychology*
chemical_list: D008694:Methamphetamine
keywords: Barriers to treatment; Methamphetamine; Substance use disorder; Systematic review; Treatment