Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis

Craig Cumming; Lakkhina Troeung; Jesse T Young; Erin Kelty; David B Preen

doi:10.1016/j.drugalcdep.2016.10.001

Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis

Drug Alcohol Depend. 2016 Nov 1:168:263-273. doi: 10.1016/j.drugalcdep.2016.10.001. Epub 2016 Oct 6.

Authors

Craig Cumming¹, Lakkhina Troeung², Jesse T Young³, Erin Kelty², David B Preen²

Affiliations

¹ Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia. Electronic address: craig.cumming@uwa.edu.au.
² Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
³ Centre for Health Service Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie St, Carlton, Victoria 3053, Australia; National Drug Research Institute, Curtin University, Level 2, 10 Selby Street, Shenton Park, Western Australia 6008, Australia.

PMID: 27736680
DOI: 10.1016/j.drugalcdep.2016.10.001

Abstract

Background: Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified as a major public health concern. Methamphetamine treatment programmes have been effective in reducing and ceasing use, however a range of barriers have prevented these programmes being widely adopted by methamphetamine users. This review examines the barriers to accessing meth/amphetamine treatment identified in the literature.

Methods: Databases were systematically searched using relevant terms for peer-reviewed articles describing original research exploring the barriers to accessing treatment for meth/amphetamine use. Reviews and grey literature were excluded. Eleven studies conducted in 5 countries were included in data synthesis; this involved a systematic review of all 11 studies, and meta-analysis of the prevalence of barriers reported in 6 studies that published sufficient quantitative data.

Results: Psychosocial/internal barriers to accessing methamphetamine treatment were most prevalent across studies (10/11 studies). Meta-analysis confirmed the four most commonly endorsed barriers to treatment access across studies all psychosocial barriers were embarrassment or stigma (60%, 95% CI: 54-67%); belief that treatment was unnecessary (59%, 95% CI:54-65%); preferring to withdraw alone without assistance (55%, 95% CI:45-65); and privacy concerns (51%, 95% CI:44-59%).

Conclusions: The primary barriers to accessing methamphetamine treatment are psychosocial/internal. Services and treatment models that address these barriers are urgently required. There is a growing need for methamphetamine-appropriate treatment services. Further research evaluating treatment engagement and effectiveness for methamphetamine and polysubstance use, including the development of effective pharmacotherapies is warranted.

Keywords: Barriers to treatment; Methamphetamine; Substance use disorder; Systematic review; Treatment.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Amphetamine-Related Disorders / psychology*
Amphetamine-Related Disorders / therapy
Culture
Humans
Methamphetamine*
Social Stigma
Treatment Refusal / psychology*

Substances

Methamphetamine