Fisher Dennis G, Reynolds Grace L, D'Anna Laura H, Hosmer David W, Hardan-Khalil Kholoud
Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA.
Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA.
J Subst Abuse Treat. 2017 Feb;73:55-62. doi: 10.1016/j.jsat.2016.11.004. Epub 2016 Nov 16.
Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at interview (OR=0.91), and sexual orientation, with bisexual men and women significantly more likely than heterosexuals to have tried but been unable to get into treatment. The answers to the question on "why were you unable to get into treatment" included: No room, waiting list; not enough money, did not qualify, got appointment but no follow through, still using drugs, and went to jail before program start. As expected, findings suggest that limiting organizational and financial obstacles to treatment may go a long way in increasing drug abuse treatment accessibility to individuals in need. Additionally, our study points to the importance of developing approaches for increasing personal planning skills/reducing Nonplanning impulsivity among PWUDs when they are in treatment as a key strategy to ensure access to additional substance abuse treatment in the future.
在美国的药物滥用者中,能够获得药物滥用治疗的人数与需要治疗的人数之间存在很大差距。这导致了一个关于治疗可及性的重大公共卫生问题。本研究的目的是考察阻碍或促进药物使用者(PWUDs)获得治疗的特征。对2646名参与者进行了风险行为评估(RBA)和巴拉特冲动性量表测试。RBA包括一个因变量,即对“在过去一年里,你是否曾试图进入药物治疗或戒毒项目,但未能成功?”这一问题的回答。在多变量分析中,与无法获得治疗相关的因素包括:曾接受过药物治疗(OR = 4.51)、过去30天服用苯丙胺的天数(OR = 1.18)、以性交易换取毒品(OR = 1.53)、无家可归(OR = 1.73)、巴拉特冲动性量表的非计划性分量表(OR = 1.19)、访谈时的年龄(OR = 0.91)以及性取向,双性恋男性和女性比异性恋者更有可能曾试图进入治疗但未能成功。关于“你为什么无法进入治疗”这一问题的回答包括:没有床位、在等候名单上;钱不够、不符合条件、得到预约但未跟进、仍在使用毒品以及在项目开始前入狱。正如预期的那样,研究结果表明,减少治疗的组织和经济障碍对于增加有需要的个人获得药物滥用治疗的机会可能大有帮助。此外,我们的研究指出,当PWUDs接受治疗时,开发提高个人计划技能/减少非计划性冲动的方法作为确保他们未来能够获得更多药物滥用治疗的关键策略的重要性。