Columbia University Irving Medical Center, Department of Psychiatry, Division on Substance Use Disorders and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10030, United States of America.
Teachers College, Columbia University, Department of Counseling & Clinical Psychology, 525 W. 120th Street, New York, NY 10027, United States of America.
J Subst Abuse Treat. 2022 Sep;140:108828. doi: 10.1016/j.jsat.2022.108828. Epub 2022 Jun 16.
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations experience opioid-related disparities compared to heterosexual and cisgender populations. LGBTQ-specific services are needed within opioid use disorder (OUD) treatment settings to minimize treatment barriers; research on the availability and accessibility of such services is limited. The purpose of the current study was to mimic the experience of an LGBTQ-identified individual searching for LGBTQ-specific OUD treatment services, using the SAMHSA National Directory of Drug and Alcohol Abuse Treatment Facilities - 2018 (Treatment Directory).
We contacted treatment facilities listed in the Treatment Directory as providing both medications for OUD (MOUD) and "special programs/groups" for LGBTQ clients within states with the top 20 highest national opioid overdose rates. We used descriptive statistics to characterize the outcome of calls; and the overall number of facilities offering LGBTQ-specific services, MOUD, and both LGBTQ-specific services and MOUD in each state by 100,000 state population and in relation to opioid overdose mortality rates (programs-per-death rate).
Of the N = 570 treatment facilities contacted, n = 446 (78.25 %) were reached and answered our questions. Of n = 446 reached (all of which advertised both MOUD and LGBTQ-specific services), n = 366 (82.06 %) reported offering MOUD, n = 125 (28.03 %) reported offering special programs or groups for LGBTQ clients, and n = 107 (23.99 %) reported offering both MOUD and LGBTQ-specific services. Apart from Washington, DC, New Mexico, South Carolina, and West Virginia, which did not have any facilities that reported offering both MOUD and LGBTQ-specific services, Illinois had the lowest, and Michigan had the highest programs-per-death rate. Most of the northeastern states on our list (all but New Hampshire) clustered in the top two quarters of programs-per-death rates, while most of southeastern states (all but North Carolina) clustered in the bottom two quarters of programs-per-death rates.
The lack of LGBTQ-specific OUD treatment services may lead to missed opportunities for supporting LGBTQ people most in need of treatment; such treatment is especially crucial to prevent overdose mortality and improve the health of LGBTQ populations across the United States, particularly in the southeast.
与异性恋和顺性别群体相比，女同性恋、男同性恋、双性恋、跨性别和酷儿（LGBTQ）群体在阿片类药物相关问题上存在差异。在阿片类药物使用障碍（OUD）治疗环境中需要提供专门针对 LGBTQ 的服务，以最大程度减少治疗障碍；但是，关于此类服务的可及性和可及性的研究有限。本研究的目的是使用 SAMHSA 国家药物和酒精滥用治疗设施目录-2018（治疗目录）模拟一名 LGBTQ 认同者寻找专门针对 LGBTQ 的 OUD 治疗服务的体验。
我们联系了治疗目录中列出的治疗设施，这些治疗设施在国家药物和酒精滥用治疗设施目录-2018（治疗目录）中声称提供阿片类药物使用障碍（OUD）的药物治疗（MOUD）和 LGBTQ 客户的“特殊计划/团体”，这些治疗设施所在的州的全国阿片类药物过量死亡率最高。我们使用描述性统计来描述呼叫结果；并根据州人口每 10 万人和与阿片类药物过量死亡率相关的每个州提供 LGBTQ 特定服务、MOUD 以及 LGBTQ 特定服务和 MOUD 的设施总数，按州列出每个州提供 LGBTQ 特定服务的设施数量、MOUD 和两者的数量。
在联系的 N = 570 个治疗设施中，n = 446（78.25％）被联系到并回答了我们的问题。在 n = 446 个联系到的治疗设施中（均声称提供 MOUD 和 LGBTQ 特定服务），n = 366（82.06％）报告提供 MOUD，n = 125（28.03％）报告提供 LGBTQ 客户的特殊计划或团体，n = 107（23.99％）报告提供 MOUD 和 LGBTQ 特定服务。除了没有任何报告提供 MOUD 和 LGBTQ 特定服务的华盛顿特区、新墨西哥州、南卡罗来纳州和西弗吉尼亚州之外，伊利诺伊州的设施数量最少，密歇根州的死亡率最高。我们名单上的大多数东北部州（除了新罕布什尔州）都集中在前两个季度的死亡率中，而东南部的大多数州（除了北卡罗来纳州）都集中在后两个季度的死亡率中。
缺乏专门针对 LGBTQ 的 OUD 治疗服务可能会导致错失为最需要治疗的 LGBTQ 人群提供支持的机会；这种治疗对于预防阿片类药物过量死亡和改善美国 LGBTQ 人群的健康尤其重要，特别是在东南部。
