Nelson Lonnie A, Collins Susan E, Shinagawa Emma, Park Sooyoun, Rajeev Vaishali, McPhail Grace, Saplan Sage, Taylor Emily M, Aguilar-Bonnette Aaron T, Mednansky Sage, Douthitt Jessica, King Roxanna J, Taylor Mark A, Kominsky Terrence K, Green Charity, Saxon Andrew J, Clifasefi Seema L
College of Nursing, Washington State University.
Department of Psychology, Washington State University.
Psychol Addict Behav. 2025 Feb;39(1):1-13. doi: 10.1037/adb0001037. Epub 2025 Jan 9.
Both opioid misuse and overdose mortality have disproportionately impacted the American Indian population. Although medications for opioid use disorder, such as buprenorphine (BUP-NX), are highly effective in reducing overdose mortality, questions have been raised about the cultural acceptability of Western medical approaches in this population. Understanding patients' desired recovery pathways can lead to more culturally appropriate, patient-centered, and effective approaches to opioid use disorder (OUD) treatment. In this qualitative study, we document experiences with combined pharmacobehavioral treatment for OUD and suggestions for enhancing it.
Participants ( = 45) were American Indian patients and community members impacted by OUD. They participated in one-time, 45- to 60-min, semistructured interviews.
Findings from conventional content analysis indicated participants were grateful for a Tribally run combined pharmacobehavioral OUD treatment program, which made treatment more financially and geographically accessible over a large, rural area. Participants expressed satisfaction with BUP-NX and the accompanying behavioral health programming but were interested in making it more accessible through telemedicine appointments and mailed prescriptions. Participants noted the importance of clear communication about this kind of programming, which tends to be less structured than other substance-use treatment programs, but also appreciated its tailored, compassionate, and holistic approach. Participants were interested in robust counseling options; a low-barrier, acceptance-based, and harm-reduction orientation; as well as more culturally aligned programming that honored their Native heritage and traditional medicine.
Treatment providers, researchers, and policymakers should consider integration of more patient-driven, compassionate, and culturally aligned means of intervention for American Indian patients with OUD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
阿片类药物滥用和过量用药死亡率对美国印第安人群体产生了尤为严重的影响。尽管用于阿片类药物使用障碍的药物，如丁丙诺啡（BUP-NX），在降低过量用药死亡率方面非常有效，但西方医学方法在该人群中的文化可接受性受到了质疑。了解患者期望的康复途径可以带来更符合文化背景、以患者为中心且有效的阿片类药物使用障碍（OUD）治疗方法。在这项定性研究中，我们记录了OUD联合药物行为治疗的经验以及改进建议。
参与者（n = 45）为受OUD影响的美国印第安患者和社区成员。他们参加了时长45至60分钟的一次性半结构化访谈。
传统内容分析的结果表明，参与者对部落运营的OUD联合药物行为治疗项目心怀感激，该项目使治疗在广大农村地区的经济可及性和地理可及性更高。参与者对BUP-NX及配套的行为健康规划表示满意，但希望通过远程医疗预约和邮寄处方使其更易获得。参与者指出了清晰传达此类项目的重要性，这类项目往往比其他物质使用治疗项目的结构更松散，但他们也赞赏其量身定制、富有同情心和整体性的方法。参与者对丰富的咨询选项感兴趣；倾向于低门槛、基于接纳和减少伤害的导向；以及更符合文化背景、尊重其本土传统和传统医学的项目。
治疗提供者、研究人员和政策制定者应考虑为患有OUD的美国印第安患者整合更多由患者驱动、富有同情心且符合文化背景的干预手段。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
