Online Program

Medical care experiences of people who use drugs: Considerations for development of accessible services

Monday, November 2, 2015 : 10:30 a.m. - 10:50 a.m.

Amy B. Jessop, PhD, MPH, Department of Health Policy and Public Health, University of the Sciences in Philadelphia, Philadelphia, PA
Tamar Klaiman, PhD, MPH, Department of Health Policy and Public Health, HepTREC at University of the Sciences in Philadelphia, Philadelphia, PA
Silvana Mazzella, MA, Prevention Point Philadelphia, Philadelphia, PA
Jose Benitez, MSW, Prevention Point Philadelphia, Philadelphia, PA
Kelly Lipman, MPH, HepTREC @ University of the Sciences in Philadelphia, Philadelphia
Stephanie Richardson, BS, University of the Sciences in Philadelphia, Philadelphia, PA
Background: ACA facilitates medical care access for many Americans, but barriers remain for those with psycho-social concerns.  People who use drugs (PWUD), particularly people who inject drugs (PWID), face health problems affecting all Americans and those related to drug use and associated lifestyles. Despite increased care need, PWID receive fewer healthcare services.  This project examines attitudes about healthcare access and experiences of PWID in order to develop more accessible healthcare services for PWID.

Methods: In-depth interviews were recorded with 20 PWUD (15 men and 5 women, injectors and non-injectors) at Prevention Point Philadelphia, a multi-service public health organization dedicated to harm reduction in Philadelphia PA. Transcripts were reviewed and coded with emergent themes identified and discussed.

Results:A perceived hierarchy of judgment in healthcare settings was noted by type and method of use, with heroin users viewed as “bad” and injectors as “worst”. A perceived hierarchy of trust in healthcare professionals was noted with physicians viewed as most and office staff as least trustworthy. Healthcare ranged from none, to ER visits, regular mental healthcare, and regular primary or subspecialty care. Most subjects had Medicaid insurance and reported Prevention Point actively assisted with their application. Respect, reported as providers seeing and treating a PWUD as a person rather than a drug problem, led attributes of trusted and acceptable providers.

Conclusions: PWUD want and seek medical care. Concerns of judgment and respect impede provider-patient relationships. Harm reduction training for all staff, from physicians to receptionists, will benefit patients and medical practices.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public
Public health or related nursing

Learning Objectives:
Describe medical care experiences of people who use drugs Describe perceptions of care and providers that impact access to care Discuss means to improve care for a vulnerable and underserved population

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in research and program development for health issues of people who inject drugs for 18 years. I serve as Director of the organization leading this project. I designed , participated in the implementation and analysis of the work presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.