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The impact of PSTD on service access among people who use drugs in Vancouver, Canada Goytan, Annemarie; Lee, William; Dong, Huiru; Hayashi, Kanna; Milloy, M-J; Kerr, Thomas

Abstract

Background Settings throughout the United States and Canada are contending with high rates of drug-related overdose. This in turn has prompted efforts to more effectively engage people who use drugs (PWUD) in treatment and care. However, while co-morbid mental disorders are prevalent among PWUD and can undermine access to services, the impact of post-traumatic stress disorder (PTSD) on service access is not known. Therefore, we sought to assess whether PTSD is associated with difficulties accessing health and social services among PWUD in Vancouver, Canada. Methods Survey data was derived from two prospective cohorts of PWUD in Vancouver, Canada for the period of April 2017 to November 2018. PTSD was assessed using the PTSD Checklist for the DSM-V (PCL-5). Generalized estimating equations (GEE) was used to estimate the relationship between PTSD and self-reported inability to access health and social services, after adjustment for confounders. Results Among 810 participants included in our analysis, 316 (39.0%) participants qualified for a provisional PSTD diagnosis, and 117 (14.4%) reported difficulties accessing services. In a multivariable GEE analysis, a PTSD diagnosis (adjusted odds ratio = 1.69, 95% confidence interval: 1.12–2.55) was independently associated with difficulties accessing services. Conclusions We found high rates of PTSD and self-reported difficulties accessing services among PWUD in Vancouver, as well as a positive association between PTSD and difficulties with service access. These findings highlight the need for trauma-informed approaches to service delivery for PWUD, as well as enhanced provider training specific to PTSD.

Item Metadata

Title
The impact of PSTD on service access among people who use drugs in Vancouver, Canada
Creator
Goytan, Annemarie; Lee, William; Dong, Huiru; Hayashi, Kanna; Milloy, M-J; Kerr, Thomas
Contributor
British Columbia Centre on Substance Use
Publisher
BioMed Central
Date Issued
2021-06-26
Description
Background Settings throughout the United States and Canada are contending with high rates of drug-related overdose. This in turn has prompted efforts to more effectively engage people who use drugs (PWUD) in treatment and care. However, while co-morbid mental disorders are prevalent among PWUD and can undermine access to services, the impact of post-traumatic stress disorder (PTSD) on service access is not known. Therefore, we sought to assess whether PTSD is associated with difficulties accessing health and social services among PWUD in Vancouver, Canada. Methods Survey data was derived from two prospective cohorts of PWUD in Vancouver, Canada for the period of April 2017 to November 2018. PTSD was assessed using the PTSD Checklist for the DSM-V (PCL-5). Generalized estimating equations (GEE) was used to estimate the relationship between PTSD and self-reported inability to access health and social services, after adjustment for confounders. Results Among 810 participants included in our analysis, 316 (39.0%) participants qualified for a provisional PSTD diagnosis, and 117 (14.4%) reported difficulties accessing services. In a multivariable GEE analysis, a PTSD diagnosis (adjusted odds ratio = 1.69, 95% confidence interval: 1.12–2.55) was independently associated with difficulties accessing services. Conclusions We found high rates of PTSD and self-reported difficulties accessing services among PWUD in Vancouver, as well as a positive association between PTSD and difficulties with service access. These findings highlight the need for trauma-informed approaches to service delivery for PWUD, as well as enhanced provider training specific to PTSD.
Subject
Post-traumatic stress disorder; Drug use; Mental health; Trauma; Healthcare; Service access
Genre
Article
Type
Text
Language
eng
Date Available
2021-07-13
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0400148
URI
http://hdl.handle.net/2429/78977
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of; Population and Public Health (SPPH), School of
Citation
Substance Abuse Treatment, Prevention, and Policy. 2021 Jun 26;16(1):53
Publisher DOI
10.1186/s13011-021-00390-x
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
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Rights

Attribution 4.0 International (CC BY 4.0)