Understanding healthcare engagement for people who inject drugs.
Omeid Heidari, Abigail Winiker, Derek T Dangerfield and 4 others
PMID 37982368WHAT IT FOUND
People who inject drugs described staying engaged when clinics helped with insurance, housing and costs, providers were trusted and nonjudgmental, and substance use, mental health and primary care were integrated.
Key findings
01Participants described clinic navigation and wrap-around help with insurance, costs, housing, disability and food assistance as key to staying engaged.
02Participants described trusting provider relationships, integrated primary care, mental health and substance use services, and care matching their perceived needs as facilitating engagement.
03Most participants said medication for opioid use disorder helped them reduce or abstain from drug use, while some expressed stigma and preferred detox plus group counseling.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in Baltimore, where participants had access to services and expanded Medicaid that may not exist for people who inject drugs elsewhere. It included only 24 interviews with people who had at least two chronic physical or mental health conditions and long injection histories, so it may not reflect people with fewer conditions or shorter histories. The interviews occurred before the COVID-19 pandemic, so telehealth and other service changes were not captured. The study describes patient experiences and cannot show that any service, provider behavior or medication caused improved engagement. Stigma toward medication for opioid use disorder emerged indirectly, not as a directly measured outcome.
The easy way to misread this
Do not read these themes as proof that wrap-around services, integrated care, or medication for opioid use disorder improve outcomes. The study asked 24 people who inject drugs to describe their experiences; it did not test an intervention or measure clinical outcomes.