Search

Abstract Background There are gaps in our understanding of treatment needs among people who use methamphetamine. We examined the demographics, perceived treatment needs, barriers to accessing care, and stigma experienced by an inpatient sample of people who use methamphetamine. Methods This study surveyed a convenience sample of patients admitted to psychiatry wards with a history of methamphetamine use in Winnipeg, Canada, between May 1 and July 31, 2019. The Perceived Need for Care Questionnaire (PNCQ-9) was used to assess treatment needs and barriers to care, and the Substance Use Stigma Mechanisms Scale (SU-SMS) was used to assess enacted, anticipated, and internalized stigma. Prevalence rates of perceived need, stigma, and demographic variables were determined. Results A total of 103 potential participants were identified, with 34 completing the survey. The most common age group was 21–30 years of age (41.2%); an approximate equal number of men and women; and almost all were single and never married (91.1%). Rates of perceived need for care were very high across all treatment types, including 91% identifying a need for medication treatment for their mental health or substance use. Despite the majority receiving care across the seven types of care described in the PNCQ-9, most felt they did not receive enough care. Unmet need for care was therefore high in many categories, including rates of 87% for counselling and skills training. The most common barriers to having needs met were a desire to self-manage substance use, and not receiving care after asking for help. Almost all participants reported experiencing stigma (94%). Stigma from family was endorsed significantly more than stigma from health care providers (p = 0.005). Conclusions The average hospitalized person who uses methamphetamine in this sample is young, single, and has not completed any post-secondary education. High rates of perceived treatment need suggest an awareness of problems with methamphetamine, yet most interventions are perceived as inadequate. People who used methamphetamine felt highly stigmatized, particularly by their family members. Trial registration Registered with the Health Research Ethics Board at the University of Manitoba (Number HS22605 (H2019:072), renewed February 14, 2022).

ABSTRACT Objective The objective of this population health research is to identify the social burden associated with having an alcohol related diagnosis. Methods We used linkable population-based administrative data files held in the Population Health Research Data Repository to conduct our research, fiscal years 1990/91 to 2014/15. Data came from several domains including health, social services, justice, and the Canadian Census. We used ICD-9/10-CA codes from the hospital abstract database, medical claims data, and prescription drug data to identify individuals with an alcohol-related diagnosis. Individuals’ socioeconomic status was determined using neighbourhood-level income data from the Canadian Census. We matched, 3:1, diagnosed cases to individuals in our repository using on age, sex, income, and community area. We linked cases and matches to administrative data from justice and social services to identify social outcomes associated with having an alcohol-related diagnosis. Outcomes included receipt of income assistance, residence in publically funded social housing, having a child apprehended by child and family protective services, having a charge for driving under the influence recorded in the justice data, and having a charge for domestic violence recorded in the justice data. We modelled rates using generalized estimating equations from 5 years before date of diagnosis to a maximum of 20 years after date of diagnosis. Models tested for significant differences in rates between cases and matches both before and after diagnosis; as well, we tested for time trends in rates both before and after diagnosis. Results We identified 52,991 individuals with an alcohol related diagnosis between 1990/91 and 2014/15: 34,145 males and 18,846 females. 80.3% of cases had a mental-health related alcohol diagnosis. Diagnoses followed a socioeconomic gradient with the greatest number of cases coming from low-income neighbourhoods. Cases had a significant spike in rates from one year before to one year after diagnosis date, compared with matches, across all indicators. When we followed individuals for 20 years after diagnosis, we found a significantly elevated rate of social service use and involvement with the justice system, across all outcomes, for all years. Conclusion Receiving an alcohol-related diagnosis is associated with subsequent increased use of social services and contacts with the justice system. Upstream efforts to reduce alcohol-related diagnoses may result in reduced use of social services and justice contacts.

Background: There are gaps in our understanding of treatment needs among people who use methamphetamine. We examined the demographics, perceived treatment needs, barriers to accessing care, and stigma experienced by an inpatient sample of people who use methamphetamine. Methods: This study surveyed a convenience sample of patients admitted to psychiatry wards with a history of methamphetamine use in Winnipeg, Canada, between May 1 and July 31, 2019. The Perceived Need for Care Questionnaire (PNCQ-9) was used to assess treatment needs and barriers to care, and the Substance Use Stigma Mechanisms Scale (SU-SMS) was used to assess enacted, anticipated, and internalized stigma. Prevalence rates of perceived need, stigma, and demographic variables were determined. Results: A total of 103 potential participants were identified, with 34 completing the survey. The most common age group was 21–30 years of age (41.2%); an approximate equal number of men and women; and almost all were single and never married (91.1%). Rates of perceived need for care were very high across all treatment types, including 91% identifying a need for medication treatment for their mental health or substance use. Despite the majority receiving care across the seven types of care described in the PNCQ-9, most felt they did not receive enough care. Unmet need for care was therefore high in many categories, including rates of 87% for counselling and skills training. The most common barriers to having needs met were a desire to self-manage substance use, and not receiving care after asking for help. Almost all participants reported experiencing stigma (94%). Stigma from family was endorsed significantly more than stigma from health care providers (p = 0.005). Conclusions: The average hospitalized person who uses methamphetamine in this sample is young, single, and has not completed any post-secondary education. High rates of perceived treatment need suggest an awareness of problems with methamphetamine, yet most interventions are perceived as inadequate. People who used methamphetamine felt highly stigmatized, particularly by their family members. Trial registration Registered with the Health Research Ethics Board at the University of Manitoba (Number HS22605 (H2019:072), renewed February 14, 2022). [ABSTRACT FROM AUTHOR]