Abstract

The increasing prevalence of drug use as well as a large number of drug users not seeking treatment is a major concern in Sri Lanka. Drug abuse treatment providers are in a unique position to identify barriers that deter drug users from accessing their services. Hence this study aimed to explore the service providers' perceptions of the barriers to drug users accessing treatment services. A qualitative study was conducted with 12 purposely selected service providers from drug treatment centres representing government, non-government, health and non-health sector institutions in the Western Province. In-depth interviews using a semi-structured questionnaire were used as the data collection method. All interviews were conducted by the Principal Investigator and were manually and digitally recorded. Interview data were transcribed and analysed using the inductive thematic analysis method. Five main themes emerged from the data. The main themes were easily identified as being drug user-related factors and service provider-related factors.  Poor drug-related health literacy and negative environmental influences were drug user-related factors which service providers perceived as barriers. Service providers perceived that poor provider training, bureaucratic challenges and poor interagency cooperation are barriers within their own programmes that act as barriers for drug users when accessing treatment services. Service providers perceived that drug users who require treatment confront numerous barriers when accessing the help, they need. It is important to address these barriers in order to improve treatment services for this marginalized group.

Keywords

Treatment access, Barriers, Drug abuse, Service providers, Drug users,

Metrics

Metrics Loading ...

References

  1. Beletsky, L., & Davis, C. S. (2017). Today ’ s fentanyl crisis : Prohibition ’ s Iron Law , revisited. International Journal of Drug Policy, 46, 156–159. https://doi.org/10.1016/j.drugpo.2017.05.050
  2. Farhoudian, A., Razaghi, E., Hooshyari, Z., Noroozi, A., Pilevari, A., Mokri, A., Mohammadi, M. R., & Malekinejad, M. (2022). Barriers and Facilitators to Substance Use Disorder Treatment : An Overview of Systematic Reviews. Substance Abuse: Research and Treatment, 16, 1–11. https://doi.org/10.1177/11782218221118462
  3. Huhn, A. S., Tompkins, D., & Dunn, K. E. (2017). The relationship between treatment accessibility and preference amongst out-of-treatment individuals who engage in nonmedical prescription opioid use. Drug and Alcohol Dependance, 176(3), 139–148. https://doi.org/10.1016/j.physbeh.2017.03.040
  4. Ibrahim, F., & Kumar, N. (2009). Factors Effecting Drug Relapse in Malaysia: An Empirical Evidence. Asian Social Science, 5(12), 37–44. https://doi.org/10.5539/ass.v5n12p37
  5. Jackson, A., & Shannon, L. (2012). Barriers to receiving substance abuse treatment among rural pregnant women in Kentucky. Maternal and Child Health Journal, 16(9), 1762–1770. https://doi.org/10.1007/s10995-011-0923-5
  6. Kalivas, P. W., & O’Brien, C. (2008). Drug Addiction as a Pathology of Staged Neuroplasticity. Neuropsychopharmacology, 33(1), 166–180. https://doi.org/https://doi.org/10.1038/sj.npp. 1301564
  7. Kelly, B. C., Liu, T., Zhang, G., Hao, W., & Wang, J. (2014). Factors related to psychosocial barriers to drug treatment among Chinese drug users. Addictive Behaviors, 39(8), 1265–1271. https://doi.org/10.1016/j.addbeh.2014.04.012
  8. Liebling, E. J., Yedinak, J. L., Green, T. C., Hadland, S. E., Clark, M. A., & Marshall, B. D. L. (2016). Access to substance use treatment among young adults who use prescription opioids non-medically. Substance Abuse: Treatment, Prevention, and Policy, 11(1), 1–12. https://doi.org/10.1186/s13011-016-0082-1
  9. Mennis, J., Stahler, G. J., & Baron, D. A. (2012). Geographic Barriers to Community-Based Psychiatric Treatment for Drug-Dependent Patients. Annals of the Association of American Geographers, 102(5), 1093–1103. https://doi.org/10.1080/00045608.2012.657142
  10. Ministry of Justice Sri Lanka. (2007). Drug Dependent Persons (Treatment and Rehabilitation) ACT 54 (No. 54). Lawnet. https://www.lawnet.gov.lk/act-no-54-of-2007/
  11. National Dangerous Drugs Control Board (NDDCB). (2019a). National Prevalence Survey on Drug Use 2019. Research Division Publications, National Dangerous Drugs Control Board, Colombo, Sri Lanka. http://www.nddcb.gov.lk/Docs/research/National_Prevalence_2019.pdf
  12. National Institute on Drug Abuse (NIDA). (2018). Principles of Drug Addiction Treatment : A Research-Based Guide (Third Edition). National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services.
  13. National STD/AIDS Control Programme (NSACP). (2018). Rapid Assessment of Drug Use Patterns (RADUP) in Sri Lanka: To inform risk reduction interventions for People Who Use / Inject Drugs (PWUD/PWID). National STD/AIDS Control Program, Sri Lanka.
  14. NDDCB. (2019b). Drug Related Statistics. Research Division Publications, National Dangerous Drugs Control Board, Colombo, Sri Lanka. http://www.nddcb.gov.lk/Docs/research/Drug_Related_Statistics_2019.pdf
  15. Prangnell, A., Daly-grafstein, B., Dong, H., Nolan, S., Milloy, M., Wood, E., Kerr, T., & Hayashi, K. (2016). Factors associated with inability to access addiction treatment among people who inject drugs in Vancouver, Canada. Substance Abuse Treatment, Prevention, and Policy, 11(9), 1–8. https://doi.org/10.1186/s13011-016-0053-6
  16. Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Kristen D. Seay. (2017). Treatment Access Barriers and Disparities Among Individuals with Co-occurring Mental Health and Substance Use Disorders: An Integrative Literature Review. Journal of Substance Abuse and Treatment, 61, 47–59. https://doi.org/10.1016/j.jsat.2015.09.006.Treatment
  17. Roberts, M., Trace, M., & Klein, A. (2004). Law enforcement and supply reduction. A Drug scope Report for the Beckley Foundation Drug Policy Programme.
  18. Thomas, D. R. (2006). A General Inductive Approach for Analyzing Qualitative Evaluation Data. Amarican Journal of Evaluation, 27(2), 237–246. https://doi.org/10.1177/1098214005283748
  19. United Nations Office on Drugs and Crime (UNODC). (2019). World Drug Report 2019 (Issue May). United Nations.
  20. UNODC, World Health Organization (WHO). (2018). International Standards on Drug Use Prevention Second Updated Edition. Vienna: UNODC and WHO.
  21. UNODC. (2022). World Drug Report 2022: Executive Summary -Policy implications, United Nations.
  22. Wakeman, S. E., & Rich, J. D. (2018). Barriers to Medications for Addiction Treatment: How Stigma Kills. Substance Use and Misuse, 53(2), 330–333. https://doi.org/10.1080/10826084.2017.1363238