From November 1999 until June 2001, Philip Appel, PhD, and colleagues at the New York State Office of Alcoholism and Substance Abuse Services documented barriers to substance abuse treatment services for injection drug users in New York City and its northern suburbs.
Researchers also gathered suggestions regarding ways to address the barriers identified by injection drug users, street outreach workers, substance abuse treatment staff and government officials.
- Users of injection drugs, who were clients of street outreach programs, and other stakeholders in substance abuse treatment cited the following main barriers to treatment:
- Family or personal problems or lack of desire for treatment.
- Lack of insurance or Medicaid coverage or long waiting lists.
- Lack of uniform admissions criteria.
- Lack of transportation and treatment slots.
- Insensitivity of social services staff and police.
- Key suggestions offered for reducing treatment barriers include:
- Admit people without insurance or Medicaid and people without identification or other documents to treatment programs.
- Increase funding for transportation, treatment slots, staffing, training and case management.
- Streamline admissions.
- Offer educational and incentive programs for substance abuse treatment staff.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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