Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study
Abstract Background Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial i...
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| Language: | English |
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BMC
2024-11-01
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| Series: | Addiction Science & Clinical Practice |
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| Online Access: | https://doi.org/10.1186/s13722-024-00515-0 |
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| author | Elaine Hsiang Kishan Patel Erin C. Wilson Alexandrea Dunham Janet Ikeda Tim Matheson Glenn-Milo Santos |
| author_facet | Elaine Hsiang Kishan Patel Erin C. Wilson Alexandrea Dunham Janet Ikeda Tim Matheson Glenn-Milo Santos |
| author_sort | Elaine Hsiang |
| collection | DOAJ |
| description | Abstract Background Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial interventions demonstrate limited efficacy. While there have been numerous trials evaluating possible medications for CUD, there is a scarcity of qualitative data on the barriers and facilitators of medication-assisted treatment. Methods Semi-structured interviews were conducted with 16 participants enrolled in a phase II randomized control trial evaluating extended-release lorcaserin among MSM with CUD. Participants were asked about their motivations for enrolling in the study, attitudes towards taking a medication for CUD, barriers and facilitators of study pill adherence, and their general study experience. Interviews were analyzed using an inductive and exploratory approach to thematic analysis. Results Participants were highly motivated to reduce cocaine use and viewed pharmacotherapy as a viable and desirable treatment option. Pharmacotherapy was seen as having fewer access and adherence structural barriers compared to existing psychosocial therapies. Medication reminders facilitated pill taking, while side effects, travel, and active substance use presented barriers to study pill adherence. Disclosure of study participation within social networks was variable pointing to anticipated substance use and treatment stigma. Conclusions Our study highlights important factors affecting the acceptability and uptake of medication-assisted treatment for CUD among a diverse sample of MSM. These findings can help guide the development and implementation of future pharmacotherapy options for CUD and other substance use disorders in this key population. |
| format | Article |
| id | doaj-art-106de04a58b2408db4555faaed95bbb2 |
| institution | Kabale University |
| issn | 1940-0640 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj-art-106de04a58b2408db4555faaed95bbb22024-11-24T12:37:50ZengBMCAddiction Science & Clinical Practice1940-06402024-11-0119111010.1186/s13722-024-00515-0Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative studyElaine Hsiang0Kishan Patel1Erin C. Wilson2Alexandrea Dunham3Janet Ikeda4Tim Matheson5Glenn-Milo Santos6Department of Emergency Medicine, University of CaliforniaDepartment of Emergency Medicine, University of CaliforniaCenter for Public Health Research, San Francisco Department of Public HealthCenter on Substance Use and Health, San Francisco Department of Public HealthCenter on Substance Use and Health, San Francisco Department of Public HealthCenter on Substance Use and Health, San Francisco Department of Public HealthCenter on Substance Use and Health, San Francisco Department of Public HealthAbstract Background Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial interventions demonstrate limited efficacy. While there have been numerous trials evaluating possible medications for CUD, there is a scarcity of qualitative data on the barriers and facilitators of medication-assisted treatment. Methods Semi-structured interviews were conducted with 16 participants enrolled in a phase II randomized control trial evaluating extended-release lorcaserin among MSM with CUD. Participants were asked about their motivations for enrolling in the study, attitudes towards taking a medication for CUD, barriers and facilitators of study pill adherence, and their general study experience. Interviews were analyzed using an inductive and exploratory approach to thematic analysis. Results Participants were highly motivated to reduce cocaine use and viewed pharmacotherapy as a viable and desirable treatment option. Pharmacotherapy was seen as having fewer access and adherence structural barriers compared to existing psychosocial therapies. Medication reminders facilitated pill taking, while side effects, travel, and active substance use presented barriers to study pill adherence. Disclosure of study participation within social networks was variable pointing to anticipated substance use and treatment stigma. Conclusions Our study highlights important factors affecting the acceptability and uptake of medication-assisted treatment for CUD among a diverse sample of MSM. These findings can help guide the development and implementation of future pharmacotherapy options for CUD and other substance use disorders in this key population.https://doi.org/10.1186/s13722-024-00515-0Cocaine use disorderMedication-assisted treatmentPharmacotherapyAdherenceMen who have sex with men |
| spellingShingle | Elaine Hsiang Kishan Patel Erin C. Wilson Alexandrea Dunham Janet Ikeda Tim Matheson Glenn-Milo Santos Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study Addiction Science & Clinical Practice Cocaine use disorder Medication-assisted treatment Pharmacotherapy Adherence Men who have sex with men |
| title | Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study |
| title_full | Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study |
| title_fullStr | Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study |
| title_full_unstemmed | Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study |
| title_short | Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study |
| title_sort | barriers and facilitators to medication assisted treatment for cocaine use disorder among men who have sex with men a qualitative study |
| topic | Cocaine use disorder Medication-assisted treatment Pharmacotherapy Adherence Men who have sex with men |
| url | https://doi.org/10.1186/s13722-024-00515-0 |
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