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Women-Reported Barriers and Facilitators of Continued Engagement with Medications for Opioid Use Disorder

Author

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  • Alice Fiddian-Green

    (School of Nursing and Health Professions, University of San Francisco, San Francisco, CA 94117, USA)

  • Aline Gubrium

    (Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA)

  • Calla Harrington

    (Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA)

  • Elizabeth A. Evans

    (Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA)

Abstract

Opioid-related fatalities increased exponentially during the COVID-19 pandemic and show little sign of abating. Despite decades of scientific evidence that sustained engagement with medications for opioid use disorders (MOUD) yields positive psychosocial outcomes, less than 30% of people with OUD engage in MOUD. Treatment rates are lowest for women. The aim of this project was to identify women-specific barriers and facilitators to treatment engagement, drawing from the lived experience of women in treatment. Data are provided from a parent study that used a community-partnered participatory research approach to adapt an evidence-based digital storytelling intervention for supporting continued MOUD treatment engagement. The parent study collected qualitative data between August and December 2018 from 20 women in Western Massachusetts who had received MOUD for at least 90 days. Using constructivist grounded theory, we identified major themes and selected illustrative quotations. Key barriers identified in this project include: (1) MOUD-specific discrimination encountered via social media, and in workplace and treatment/recovery settings; and (2) fear, perceptions, and experiences with MOUD, including mental health medication synergies, internalization of MOUD-related stigma, expectations of treatment duration, and opioid-specific mistrust of providers. Women identified two key facilitators to MOUD engagement: (1) feeling “safe” within treatment settings and (2) online communities as a source of positive reinforcement. We conclude with women-specific recommendations for research and interventions to improve MOUD engagement and provide human-centered care for this historically marginalized population.

Suggested Citation

  • Alice Fiddian-Green & Aline Gubrium & Calla Harrington & Elizabeth A. Evans, 2022. "Women-Reported Barriers and Facilitators of Continued Engagement with Medications for Opioid Use Disorder," IJERPH, MDPI, vol. 19(15), pages 1-17, July.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9346-:d:876389
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    References listed on IDEAS

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    1. Metzl, Jonathan M. & Hansen, Helena, 2014. "Structural competency: Theorizing a new medical engagement with stigma and inequality," Social Science & Medicine, Elsevier, vol. 103(C), pages 126-133.
    2. Campbell, C.I. & Weisner, C. & LeResche, L. & Ray, G.T. & Saunders, K. & Sullivan, M.D. & Banta-Green, C.J. & Merrill, J.O. & Silverberg, M.J. & Boudreau, D. & Satre, D.D. & Von Korff, M., 2010. "Age and gender trends in long-term opioid analgesic use for noncancer pain," American Journal of Public Health, American Public Health Association, vol. 100(12), pages 2541-2547.
    3. El-Bassel, N. & Gilbert, L. & Wu, E. & Go, H. & Hill, J., 2005. "Relationship between drug abuse and intimate partner violence: A longitudinal study among women receiving methadone," American Journal of Public Health, American Public Health Association, vol. 95(3), pages 465-470.
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