Clinician identified barriers to treatment for individuals in Appalachia with opioid use disorder following release from prison: a social ecological approach

• DOI: 10.1186/s13722-018-0124-2
• Publication Date: 2018-12-03T12:13:57Z
• Authors: Amanda M. Bunting; Carrie B. Oser; Michele Staton; Katherine S. Eddens; Hannah Knudsen
• Keywords: Appalachia; Health psychology; Appalachian Region; Opiate Substitution Treatment

The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates overdose mortality as well increases in the prison population. Individuals with opioid disorder (OUD) are at increased risk for relapse upon reentry to community due decreased tolerance during incarceration. It is crucial identify barriers substance treatment post-release from because can be difficult access resource-limited Appalachia.A social ecological framework was utilized examine community-based among individuals OUD Appalachian Kentucky following release prison. Semi-structured qualitative interviews 15 service clinicians (SSCs) employed Department Corrections were conducted individual, interpersonal, organizational/institutional level, community, systems levels. Two independent coders line-by-line coding key themes.Treatment identified across spectrum. At individual-level, SSCs highlighted high-risk drug a lack motivation. interpersonal homogenous networks (i.e., homophilious drug-using networks) limited knowledge inhibited treatment. SSC's high case load probation/parole officer's understanding barriers. Easy opioids, few resources, support level. noted system-level such transportation options, cost, uncertainty about implementation Affordable Care Act.More infrastructure resources additional education family networks, corrections staff, large Appalachia needed address Future research should perspective other stakeholders (e.g., clients, families clients) test interventions increase