Accessing drug treatment programs in Atlantic Canada: the experiences of people who use substances

Abstract

People who use substances (PWUS) (e.g. inject substances) are at risk of many harms. Various services help reduce risks including drug treatment programs such as withdrawal management and opioid agonist treatment. Much of the research on PWUS’ experiences of treatment programs is set in large urban centers creating a knowledge gap of experiences in other places. Our study helps address this gap by exploring PWUS’ experiences of treatment programs in Atlantic Canada which is a region with many small urban centers and rural areas. One-on-one qualitative interviews were conducted with 55 PWUS focusing on their experiences of treatment program facilitators (or what helped with access and retention), and/or barriers to treatment access and retention (or what was not helpful). Data were analyzed for key themes/subthemes and organized using a slightly modified Rhodes’ risk environment framework. PWUS’ experiences of facilitators and barriers cross all four environments of treatment programs: policy and practice, physical, social, and resource environments. For some PWUS, barriers impacted their access to or retention in treatment, and hence are of serious concern given the current toxic illicit drug supply in Canada. Several barriers are shaped by drug criminalization and thus this research points to the need for decriminalization to help reduce barriers.

Keywords:

• People who use substances
• drug treatment access and retention
• qualitative research

Acknowledgements

This research was supported by the Canadian Institutes of Health Research HIV/AIDS Community-Based Research Operating Grant under Grant number CBR-156918. The authors wish to thank all the participants for giving of their time and speaking to us about their experiences with drug treatment programs. We would also like to acknowledge and thank the community-based organizations that assisted with recruitment, as well as all past and present members of the research team (known as the Atlantic COAST study team). In addition, we would like to acknowledge and remember fondly the late Dr. Margaret Dechman (2020) who was involved in the early stages of this study.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

Study participants did not agree for their data to be shared publicly, so data are not publicly available.