使用阿片类药物的人如何表现出他们的品质和能力?对态度、行为和机会的评估。
How do people who use opioids express their qualities and capacities? An assessment of attitudes, behaviors, and opportunities.
机构信息
Community Health Sciences, Berkeley Center for Cultural Humility, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
出版信息
Harm Reduct J. 2024 Apr 8;21(1):79. doi: 10.1186/s12954-024-00981-4.
People who nonmedically use drugs (PWUD) face intricate social issues that suppress self-actualization, communal integration, and overall health and wellness. "Strengths-based" approaches, an under-used pedagogy and practice in addiction medicine, underscore the significance of identifying and recognizing the inherent and acquired skills, attributes, and capacities of PWUD. A strengths-based approach engenders client affirmation and improves their capacity to reduce drug use-related harms by leveraging existing capabilities. Exploring this paradigm, we conducted and analyzed interviews with 46 PWUD who were clients at syringe services programs in New York City and rural southern Illinois, two areas with elevated rates of opioid-related morbidity and mortality, to assess respondents' perceived strengths. We located two primary thematic modalities in which strengths-based ethos is expressed: individuals (1) being and advocate and resource for harm reduction knowledge and practices and (2) engaging in acts of continuous self-actualization. These dynamics demonstrate PWUD strengths populating and manifesting in complex ways that both affirm and challenge humanist and biomedical notions of individual agency, as PWUD refract enacted, anticipated, and perceived stigmas. In conclusion, programs that blend evidence-based, systems-level interventions on drug use stigma and disenfranchisement with meso and micro-level strengths-based interventions that affirm and leverage personal identity, decision-making capacity, and endemic knowledge may help disrupt health promotion cleavages among PWUD.
非医疗用途药物使用者(PWUD)面临着复杂的社会问题,这些问题抑制了他们的自我实现、社区融合以及整体健康和幸福。“基于优势”的方法是成瘾医学中一种未被充分应用的教学法和实践,强调了识别和认识 PWUD 内在和后天技能、属性和能力的重要性。基于优势的方法通过利用现有能力,为客户提供肯定并提高他们减少与药物使用相关的伤害的能力。为了探索这一模式,我们对纽约市和伊利诺伊州南部农村地区接受注射器服务项目的 46 名 PWUD 进行了访谈和分析,这两个地区的阿片类药物相关发病率和死亡率都很高,以评估受访者感知到的优势。我们找到了两种主要的主题模式,其中表达了基于优势的理念:个人(1)成为和倡导和资源,以减少伤害知识和实践,以及(2)不断自我实现的行为。这些动态表明,PWUD 的优势以复杂的方式表现出来,既肯定了也挑战了人文主义和生物医学的个体能动性概念,因为 PWUD 折射出实施、预期和感知到的污名。总之,将基于证据的、系统层面的药物使用污名和剥夺权利干预措施与肯定和利用个人身份、决策能力和地方性知识的中观和微观层面的基于优势的干预措施相结合的项目可能有助于打破 PWUD 之间的健康促进分裂。