Factors Associated with Interest in Substance Use Treatment Among Syringe Exchange Clients Who Use Opioids

Abstract

Background: Opioid use disorder (OUD) is a growing problem across the United States. Despite the existence of effective, evidence-based treatments, the majority of people with OUD do not receive treatment. Increasing treatment receipt is an essential component of the public health response to the opioid crisis. This study examines factors associated with interest in treatment among opioid-using syringe exchange program (SEP) clients. Methods: Survey data were collected at 17 SEPs in 16 counties across Washington State during 2015; 438 respondents reported current opioid use and not receiving current treatment, and thus were eligible for the analysis. Cross-sectional bivariate analyses and multivariate logistic regression were conducted to examine factors associated with interest in treatment (measured as reporting being somewhat or very interested in getting help to reduce or cease drug use), including demographic and social characteristics, drug use behaviors and consequences, and factors related to access and use of health care services. Results: The majority of participants in this study reported interest in treatment (77.6%). In multivariate analyses, factors independently positively associated with interest in treatment included: female gender (AOR=1.84; 95% CI: 1.07, 3.13), having an abscess in the past year (AOR=1.91; 95% CI: 1.10, 3.32), and having received treatment services in the past year (AOR=6.37; 95% CI: 2.47, 16.40). Factors independently negatively associated with interest in treatment included: older age (AOR=0.76; 95% CI: 0.58, 0.99 for ten-year increase), methamphetamine use in the past three months (AOR=0.46; 95% CI: 0.25, 0.86) and pharmaceutical opioid use in the past three months (AOR=0.56; 95% CI: 0.33, 0.94). Conclusions: Public health and health care professionals who work with people who use opioids should consider factors associated with interest in treatment when planning treatment engagement interventions. Future research is needed to assess the generalizability of these findings and to better understand why certain factors may be positively or negatively associated with treatment interest.