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治愈之旅:从阿片类药物使用中康复的第一民族个体的经历。

Healing journey: Experiences of First Nations individuals with recovery from opioid use.

机构信息

Associate Professor in the Division of Clinical Sciences at NOSM University in Sioux Lookout, Ont.

Anishininiiw Nanadowi'kikendamowin Program Manager at Sioux Lookout First Nations Health Authority.

出版信息

Can Fam Physician. 2024 Feb;70(2):117-125. doi: 10.46747/cfp.7002117.

Abstract

OBJECTIVE

To understand experiences of recovery from opioid use among First Nations individuals living in a small remote community.

DESIGN

Qualitative phenomenologic study.

SETTING

Northwestern Ontario.

PARTICIPANTS

Sixteen First Nations individuals living in a remote community who had participated in or completed the community opioid agonist therapy program.

METHODS

Extensive community consultation took place to ensure local acceptance of the study and permission for publication. Semistructured telephone interviews with consenting participants were audiorecorded between November and December 2021 and transcribed. Transcripts were reviewed and discussed in meetings with Indigenous and non-Indigenous research team members who conducted thematic analysis using immersion and crystallization.

MAIN FINDINGS

Participants described their opioid use as a form of self-management of trauma. Their recovery processes were multifaceted and included developing cultural and self-awareness. Motivation for change often arose from concerns about family well-being and finances. Traditional cultural practices and time spent on the land were identified as important wellness experiences. Barriers to healing included limited clinical and holistic addiction services, particularly around dose weaning and opioid agonist therapy discontinuation.

CONCLUSION

Community-based addiction programming for First Nations patients needs to be robust. It requires resources for trauma-informed clinical and addiction care, culturally appropriate addictions education, aftercare support, and land-based activities.

摘要

目的

了解居住在一个偏远小型社区的第一民族个体从阿片类药物使用中康复的体验。

设计

定性现象学研究。

地点

安大略省西北部。

参与者

16 名居住在偏远社区的第一民族个体,他们曾参加或完成过社区阿片类激动剂治疗计划。

方法

进行了广泛的社区咨询,以确保研究得到当地的认可,并允许发表。2021 年 11 月至 12 月期间,与同意参与的参与者进行了半结构化电话访谈,并对其进行了录音和转录。研究团队的土著成员和非土著成员对转录本进行了审查和讨论,他们使用沉浸和结晶的方法进行了主题分析。

主要发现

参与者将他们的阿片类药物使用描述为一种创伤自我管理的形式。他们的康复过程是多方面的,包括培养文化和自我意识。改变的动机通常源于对家庭幸福和经济状况的担忧。传统的文化习俗和在土地上的时间被确定为重要的健康体验。康复的障碍包括临床和整体成瘾服务有限,特别是在剂量逐渐减少和阿片类激动剂治疗停止方面。

结论

针对第一民族患者的社区成瘾计划需要加强。它需要资源来提供以创伤为中心的临床和成瘾护理、文化上适当的成瘾教育、康复后的支持以及基于土地的活动。

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