Evidence map›Paper›PMID 34134865›Full record

ArticleJournal of substance abuse treatment2021

Treatment trajectories and barriers in opioid agonist therapy for people who inject drugs in rural Puerto Rico.

Roberto Abadie, Katherine McLean, Patrick Habecker, Kirk Dombrowski

Abstract read
In one paragraph

Article in Journal of substance abuse treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Roberto AbadieDepartment of Anthropology, University of Nebraska-Lincoln, 839 Old Father Hall, Lincoln, NE 68588, United States of America. Electronic address: rabadie2@unl.edu.
Katherine McLeanDepartment of Administration of Justice, Penn State Greater Allegheny, 400 University Drive, McKeesport, PA 15216, United States of America.
Patrick HabeckerDepartment of Sociology, University of Nebraska-Lincoln, 430 Old Father Hall, Lincoln, NE 68588, United States of America.
Kirk DombrowskiDepartment of Anthropology, University of Vermont, 72 University Place, VT 05405, United States of America.

Funding

Biomarkers for Dysbiosis-Related HIV-Associated Cognitive Disorders among Persons Who Inject Drugs in Puerto RicoR01DA047823 · NIDA · UNIVERSITY OF NEBRASKA LINCOLN · PI WOOD, CHARLES · 2019 to 2024
$2.5M
Assessing the effects of hurricane Maria on Opioid Agonist Treatment access among PWID in rural Puerto RicoR21DA047304 · NIDA · UNIVERSITY OF NEBRASKA LINCOLN · PI ABADIE, ROBERTO, HABECKER, PATRICK · 2018 to 2019
$413k
NIDA NIH HHS R01 DA047823NIDA NIH HHS R21 DA047304
6 · The paper itself

Abstract

backgroundResearch has shown medication for opioid use disorder (MOUD) to have positive effects, including reducing HIV and HCV transmission, but important barriers to access remain among people who inject drugs (PWID). Barriers include lack of social and familial support, bureaucracy, distance to treatment, poverty, and homelessness. However, we know little about how these barriers interact with each other to shape PWID's drug treatment access and retention.

methodsWe used qualitative methods with a dataset from a study conducted during 2019 with 31 active PWID residing in rural Puerto Rico. The study gathered ethnographic data and narratives about treatment trajectories to document the lived experiences of PWID as they moved in and out of treatment.

resultsParticipants were at least 18 years old; 87.7% were male, the mean age was 44.1 years, and the mean age at first injection was 22 years. Participants identified homelessness, lack of proper ID or other identifying documents, and previous negative experiences with MOUD as the main barriers to treatment entry and retention. In addition, PWID's belief that MOUD simply substitutes an illegal drug for a legal one, while furthering drug dependence by chronically subjecting patients to treatment, constitutes an additional barrier to entry. Findings from this study demonstrate that MOUD barriers to access and retention compound and are severely affected by poverty and other forms of vulnerability among PWID in rural Puerto Rico.

conclusionPolicies to increase access and retention should consider barriers not in isolation but as an assemblage of many factors.

Indexed as

HIV InfectionsOpioid-Related DisordersPharmaceutical PreparationsSubstance Abuse, IntravenousAdolescentAdultAnalgesics, OpioidHumansMalePuerto RicoAnalgesics, OpioidPharmaceutical PreparationsBarriersOpioid agonist therapyPuerto RicoPWIDRuralTreatment trajectories

Identifiers

PMID34134865
PMCPMC8217715

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.