Choi Sugy, Choi Jasmin, O'Grady Megan, Renteria Diego, Oules Crissy, Liebmann Eddie, Lincourt Pat, Jordan Ashly E, Neighbors Charles J
Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America.
New York University School of Global Public Health, New York, NY, United States of America.
J Subst Use Addict Treat. 2025 Feb;169:209581. doi: 10.1016/j.josat.2024.209581. Epub 2024 Nov 16.
Addressing the persistent treatment gap in substance use disorder (SUD) remains a critical challenge, with only 13 % of Americans with SUDs receiving necessary treatment. We explored the complexities of engaging in SUD treatment from patients' perspectives and aims to provide a comprehensive understanding of their treatment experiences.
We conducted semi-structured interviews with 34 patients who had been attending outpatient SUD clinics in New York State for 6 or less months. Participants were recruited from seven clinics using purposive sampling. Interviews were conducted between June and August 2022. We conducted thematic analysis of coded data to explore patients' experiences and preferences while navigating their treatment journeys.
Critical elements for a positive treatment experience included cultural humility, confidentiality, consistency, trust, peer counselors with SUD experience, a strong sense of connection, and addressing needs beyond clinical settings. These included assistance with housing and employment, participation in external clinic events, and access to amenities like coffee and snacks. Participants favored holistic treatment approaches integrating mental health and involving peer recovery counselors. However, participants also identified ineffective aspects, including rigid and generic approaches, stigmatizing attitudes, and challenges related to communities and environmental influences.
The study highlights the multifaceted nature of outpatient SUD treatment, emphasizing the integration of patient-centered, holistic, and culturally competent approaches. Tailoring interventions to individual circumstances and acknowledging the diverse needs of patients are imperative for effective healthcare practices.
解决物质使用障碍（SUD）持续存在的治疗差距仍然是一项严峻挑战，只有13%的患有物质使用障碍的美国人接受了必要的治疗。我们从患者的角度探讨了参与物质使用障碍治疗的复杂性，旨在全面了解他们的治疗经历。
我们对34名在纽约州门诊物质使用障碍诊所就诊6个月或更短时间的患者进行了半结构化访谈。参与者通过目的抽样从7家诊所招募。访谈于2022年6月至8月进行。我们对编码数据进行了主题分析，以探索患者在治疗过程中的经历和偏好。
积极治疗体验的关键要素包括文化谦逊、保密性、一致性、信任、有物质使用障碍经验的同伴咨询师、强烈的联系感，以及满足临床环境之外的需求。这些需求包括住房和就业援助、参与外部诊所活动，以及获得咖啡和零食等便利设施。参与者青睐整合心理健康并涉及同伴康复咨询师的整体治疗方法。然而，参与者也指出了无效的方面，包括僵化和通用的方法、污名化态度，以及与社区和环境影响相关的挑战。
该研究强调了门诊物质使用障碍治疗的多面性，强调了以患者为中心、整体和具有文化能力的方法的整合。根据个体情况调整干预措施并认识到患者的多样化需求对于有效的医疗实践至关重要。
