Access to treatment for people with alcohol and other substance abuse problems
DOI:
https://doi.org/10.20882/adicciones.134Keywords:
Alcoholism/therapy, attitude of health personnel, physicians, primary health care psychiatrists, substance-related disorders/therapyAbstract
Objectives: IATPAD (Improvement in Access to Treatment for People withAlcohol and Drug Related Problems) is a European study. The study’smain objective was to detect barriers and facilitators associated withaccess to treatment among patients with problems related to alcohol anddrug use. This article presents the quantitative findings from Cataluña(Spain).Methods: Multicentric, cross-sectional study. Three main treatment entrypoints were assessed: General Psychiatry (CSMA), Out-patient AddictionCenters (CAS) and Primary Care (CAP). Centres were randomly selected.The Medical Condition Regard Scale was used to measure regard forworking with different patient groups (diabetes, depression, patients withproblems related to alcohol and patients with problems related to drugs).Results: Differences were detected in regard towards working withpatients with alcohol, drugs and depression by treatment entry point.Professionals from the CASs reported higher regard towards workingwith substance users than professionals from CSMAs (p<0,001) orprofessionals from CAPs (p<0,001).Conclusions: The attitudes of professionals towards patients withsubstance use disorders are important for treatment engagement.Treatment policy needs to consider how to improve staff attitudes.References
Sellman D. The 10 most important things known about addiction. Addiction 2010; 105: 6-13.
Alegria M, Perez DJ, Williams S. The role of public policies in reducing mental health status disparities for people of color. Health Aff (Millwood) 2003; 22: 51-64.
Festinger DS, Lamb RJ, Kountz MR, Kirby KC, Marlowe D. Pretreatment dropout as a function of treatment delay and client variables. Addict Behav 1995; 20: 111-5.
Hser YI, Maglione M, Polinsky ML, Anglin MD. Predicting drug treatment entry among treatment-seeking individuals. J Subst Abuse Treat 1998; 15: 213-220.
Mowbray O, Perron BE, Bohnert AS, Krentzman AR, Vaughn MG. Service use and barriers to care among heroin users: results from a national survey. Am J Drug Alcohol Abuse 2010; 36: 305-310.
Myers B, Fakier N, Louw J. Stigma, treatment beliefs, and substance abuse treatment use in historically disadvantaged communities. Afr J Psychiatry (Johannesbg) 2009; 12: 218-222.
Tucker JA, Vuchinich RE, Rippens PD. A factor analytic study of influences on patterns of help-seeking among treated and untreated alcohol dependent persons. J Subst Abuse Treat 2004; 26: 237-242.
Ding L, Landon BE, Wilson IB, Wong MD, Shapiro MF, Cleary PD. Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Arch Intern Med 2005; 165: 618-623.
Furlan PM, Laguzzi S, Rosa M, Barboni S, Roagna G, Scarso G. Attitudes, knowledge and methods of assistance used by general practitioners in Novara in treating drug addicts. Study of 100 doctors. Minerva Psichiatr 1990; 31: 145-149.
Lindberg M, Vergara C, Wild-Wesley R, Gruman C. Physicians-intraining
attitudes toward caring for and working with patients with alcohol and drug abuse diagnoses. South Med J 2006; 99:28-35.
Roche AM, Guray C, Saunders JB. General practitioners’ experiences of patients with drug and alcohol problems. Br J Addict 1991; 86: 263-275.
Tantam D, Donmall M, Webster A, Strang J. Do general practitioners and general psychiatrists want to look after drug misusers? Evaluation of a non-specialist treatment policy. Br J Gen Pract 1993; 43: 470-474.
Todd FC, Sellman JD, Robertson PJ. Barriers to optimal care for patients with coexisting substance use and mental health disorders. Aust N Z J Psychiatry 2002; 36: 792-799.
Sheridan J, Strang J, Barber N, Glanz A. Role of community pharmacies in relation to HIV prevention and drug misuse: findings from the 1995 national survey in England and Wales. BMJ 1996; 313: 272-274.
Howard MO, Chung SS. Nurses’ attitudes toward substance misusers. I. Surveys. Subst Use Misuse 2000; 35: 347-365.
Carroll J. Attitudes of professionals to drug abusers. Br J Nurs 1993; 2: 705-711.
Deehan A, Taylor C, Strang J. The general practitioner, the drug misuser, and the alcohol misuser: major differences in general practitioner activity, therapeutic commitment, and ’shared care’ proposals. Br J Gen Pract 1997; 47: 705-709.
Digiusto E, Treloar C. Equity of access to treatment, and barriers to treatment for illicit drug use in Australia. Addiction 2007; 102: 958-969.
Baldacchino A, Gilchrist G, Fleming R, Bannister J. Guilty until proven innocent: a qualitative study of the management of chronic non-cancer pain among patients with a history of substance abuse. Addict Behav 2010; 35: 270-272.
Neale J, Tompkins C, Sheard L. Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. Health Soc Care Community 2008; 16: 147-154.
Simpson CA, Tucker JA. Temporal sequencing of alcohol-related problems, problem recognition, and help-seeking episodes. Addict Behav 2002; 27: 659-674.
Brown BS, O’Grady K, Battjes RJ, Farrell EV. Factors associated with treatment outcomes in an aftercare population. Am J Addict 2004; 13: 447-460.
Gilchrist G, Moskalewicz J, Slezakova S, Okruhlica L, Torrens M, Vajd R, et al. Staff regard towards working with substance users: a European multi-centre study. Addiction 2011; 106:1114-1125.
Christison GW, Haviland MG, Riggs ML. The medical condition regard scale: measuring reactions to diagnoses. Acad Med 2002; 77: 257-262.
McGillion J, Wanigaratne S, Feinmann C, Godden T, Byrne A. GPs’ attitudes towards the treatment of drug misusers. Br J Gen Pract 2000; 50: 385-386.
Davies A, Huxley P. Survey of general practitioners’ opinions on treatment of opiate users. BMJ 1997; 314: 1173-1174.
Matheson C, Pitcairn J, Bond CM, van Teijlingen E, Ryan M. General practice management of illicit drug users in Scotland: a national survey. Addiction 2003; 98: 119-126.
Carroll KM, Ball SA, Nich C, Martino S, Frankforter TL, Farentinos C, et al. Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend 2006; 81: 301-312.
Carroll KM, Libby B, Sheehan J, Hyland N. Motivational interviewing to enhance treatment initiation in substance abusers: an effectiveness study. Am J Addict 2001; 10: 335-339.
Richards JC, Ryan P, McCabe MP, Groom G, Hickie IB. Barriers to the effective management of depression in general practice. Aust N Z J Psychiatry 2004; 38: 795-803
Dowrick C, Gask L, Perry R, Dixon C, Usherwood T. Do general practitioners’ attitudes towards depression predict their clinical behaviour? Psychol Med 2000; 30: 413-419.
Bertakis KD. The influence of gender on the doctor-patient interaction. Patient Educ Couns 2009; 76: 356-360.
Pidd K, Freeman T, Skinner N, Addy D, Shoobridge J, Roche AM. From Training to Work Practice Change: An Examination of Factors Influencing Training Transfer in the Alcohol and Other Drugs Field 2004.
