Identifying the most common barriers to opioid agonist treatment in an Australian setting
Natasha Yvonne Hall A * , Long Le B , Julie Abimanyi-Ochom A , Maree Teesson C and Cathy Mihalopoulos B
+ Author Affiliations
- Author Affiliations
A School of Health and Social Development, Deakin University, Burwood, Vic., Australia.
B Public Health and Preventative Medicine, Monash University, Melbourne, Vic., Australia.
C Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
* Correspondence to: Natasha.hall@deakin.edu.au
Australian Journal of Primary Health 29(5) 445-454 https://doi.org/10.1071/PY22269
Submitted: 1 September 2022 Accepted: 20 February 2023 Published: 20 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Opioid use disorder is a public health concern in Australia. Opioid agonist treatment (OAT) is effective at treating and minimising harm from opioid use disorder, yet is underused in Australia due to client barriers. Although these barriers have been reported, the barriers that are most important to clients is unclear. The aim of this paper was to determine the most important OAT barriers to Australian clients.
Methods: A cross-sectional, self-completed survey was given to 204 opioid-dependent clients who attended needle and syringe sites in Australia. Participants were given 15 OAT barrier statements, which they answered using a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree). The Likert scale data are presented using the count method and the mean Likert scores (for the whole sample and for subgroups).
Results: The two methods determined that the four most important barriers to OAT were stigma, lack of support services, no flexibility and enjoy using opioids. Furthermore, those who used prescription opioids (compared with heroin) were female or non-binary (compared with male), were not currently using OAT (compared with current OAT), were younger (compared with older) and had high dependence scores (compared with low dependence scores) were impacted more by certain OAT barriers.
Conclusions: Policies around improving support services, reducing stigma and increasing flexibility would be beneficial to reduce barriers to OAT in Australia. Second, certain groups were more vulnerable to OAT barriers, emphasising the importance to better tailor opioid treatment programs to these specific populations to increase treatment engagement.
Keywords: Australia, barriers to treatment, heroin dependence, Likert scale analysis, needle syringe sites, opioid agonist treatment, opioid use disorder, prescription opioid dependence.
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