Access to and use of health care: perceptions and experiences among people who use heroin and cocaine

Abstract

Objective: To examine the health care experiences of low-income drug users in order to gain insight into their health care decision-making and barriers to care.

Methods: Data come principally from open-ended interviews with 71 individuals who use or used heroin and/or cocaine. Interviews focused primarily on health status, health history, and health care received; current and former drug use; and basic demographics. Supplementary data were collected through four focus group discussions with drug users and six open-ended interviews with health care providers.

Results: Study participants had high morbidity and high utilization of health services. More than 80% of participants reported that their last health care visit occurred within the last six months; 56% of participants reported health care visits within the last two months. These visits were most often to address pressing medical needs including infections, illness, and injury.

Health care experiences were considered most favorably when providers demonstrated concern for comfort and well-being, and most unfavorably when care appeared to be affected by prejudice or preconceptions about drug use. Negative experiences with health care served to discourage consistent utilization of needed services.

Conclusions: The health care experiences described by heroin and cocaine users suggest provider ignorance and prejudice regarding this population and make evident some reasons underlying drug user avoidance of health care.

• Utilization
• Health Care Access Drug Use