Breaching Trust: A Qualitative Study of Healthcare Experiences of People Who Use Drugs in a Rural Setting
| Autor: | Lawrence J. Ouellet, Mai T. Pho, Samuel R. Friedman, Kaitlin Ellis, Jerel M. Ezell, Kris Rosentel, Suzan M. Walters |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Referral
barriers Population lcsh:HM401-1281 drugs 03 medical and health sciences 0302 clinical medicine access Nursing Sociology Health care Emergency medical services inject 030212 general & internal medicine education Protected health information Original Research Harm reduction education.field_of_study 030505 public health business.industry Law enforcement General Social Sciences healthcare lcsh:Sociology (General) stigma opioid rural Rural area 0305 other medical science business |
| Zdroj: | Frontiers in Sociology Frontiers in Sociology, Vol 5 (2020) |
| ISSN: | 2297-7775 |
| Popis: | Background: Increased drug use has disproportionately impacted rural areas across the U.S. People who use drugs are at risk of overdose and other medical complications, including infectious diseases. Understanding barriers to healthcare access for this often stigmatized population is key to reducing morbidity and mortality, particularly in rural settings where resources may be limited. Methods: We conducted 20 semi-structured interviews with people who use drugs, including 17 who inject drugs, in rural southern Illinois between June 2018 and February 2019. Interviews were analyzed using a modified grounded theory approach where themes are coded and organized as they emerge from the data. Results: Participants reported breaches of trust by healthcare providers, often involving law enforcement and Emergency Medical Services, that dissuaded them from accessing medical care. Participants described experiences of mistreatment in emergency departments, with one account of forced catheterization. They further recounted disclosures of protected health information by healthcare providers, including communicating drug test results to law enforcement and sharing details of counseling sessions with community members without consent. Participants also described a hesitancy common among people who use drugs to call emergency medical services for an overdose due to fear of arrest. Conclusion: Breaches of trust by healthcare providers in rural communities discouraged people who use drugs from accessing medical care until absolutely necessary, if at all. These experiences may worsen healthcare outcomes and further stigmatize this marginalized community. Structural changes including reforming and clarifying law enforcement's role in Emergency Departments as well as instituting diversion policies during arrests may help rebuild trust in these communities. Other possible areas for intervention include stigma training and harm reduction education for emergency medicine providers, as well as developing and implementing referral systems between Emergency Departments and local harm reduction providers and medically assisted drug treatment programs. |
| Databáze: | OpenAIRE |
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