title: Systemic and individual factors in the buprenorphine treatment-seeking process: a qualitative study.
abstract: Opioid use is a significant problem in Alaska. Medication-assisted treatment for opioid use, including buprenorphine, reduces withdrawal symptoms and the harm associated with opioid abuse. Understanding consumers' treatment-seeking process is important for addressing barriers to treatment, facilitating effective service utilization, and informing policy.
  
  
  
  To understand treatment-seeking behavior, we examined the attitudes, perceptions, and knowledge of those who would benefit from the medication-assisted treatment (MAT) buprenorphine. Qualitative data from 2 focus groups (each including 4 participants) and 3 in-depth interviews with people who have used or considered using buprenorphine in treatment for an opioid use disorder were analyzed using grounded theory and directed content analysis approaches.
  
  
  
  Key findings suggest that individual (withdrawal process, individual motivation) and systemic (sociocultural, political, societal values) factors frame the treatment seeking process. Participants' progress on the treatment-seeking road was affected by models of addiction and MAT, which related to facilitators and barriers encountered in seeking treatment (e.g. support, resources, treatment structure). These factors shaped the longer-term road to recovery, which was seen as on ongoing process.
  
  
  
  The findings of this study suggest it is crucial for interventionists to take a contextual approach that considers individual and systemic factors involved in opioid addiction, treatment, and recovery. This study highlights ways policy makers and treatment providers can address the barriers consumers face in their treatment-seeking process in order to increase treatment access.
authors.affiliation: Department of Psychology, University of Alaska Fairbanks, P.O. Box 756480, AK 99775, Fairbanks, USA. dr.valerie.hewell@gmail.com.
authors.forename: Valerie M
authors.initials: VM
authors.lastname: Hewell
authors.affiliation: Department of Psychology, University of Alaska Fairbanks, P.O. Box 756480, AK 99775, Fairbanks, USA.
authors.forename: Angel R
authors.initials: AR
authors.lastname: Vasquez
authors.affiliation: Department of Psychology, University of Alaska Fairbanks, P.O. Box 756480, AK 99775, Fairbanks, USA.
authors.forename: Inna D
authors.initials: ID
authors.lastname: Rivkin
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research
chemical_list: D002047:Buprenorphine
keywords: Medication-assisted treatment; Opioid use; Policy; Qualitative research; Treatment-seeking