Welcomeness for people with substance use disorders to general practice: a qualitative study

Area of Science:

• Public Health
• Addiction Medicine
• General Practice

Background:

• Substance use disorders (SUDs) are prevalent, necessitating effective primary care.
• Overdose deaths highlight the critical need for accessible and supportive healthcare for individuals with SUDs.

Purpose of the Study:

• To investigate the experiences of women with a history of SUDs within the criminal justice system regarding general practice care.
• To understand barriers and facilitators to accessing primary care for this population.

Main Methods:

• Qualitative study involving 65 interviews with 39 women, conducted pre- and post-release in Australian prisons and community settings.
• Thematic analysis informed by constructivist grounded theory was employed to analyze the data.

Main Results:

• Participants reported conditional welcome in general practice, often tied to non-disclosure of SUDs or unrelated health concerns.
• General practitioners (GPs) sometimes failed to distinguish between past and current substance use, leading to stigmatization.
• Difficulty finding welcoming practices and a lack of awareness about comprehensive care beyond physical health were significant issues.

Conclusions:

• Inconsistent experiences of welcome in general practice hinder healthcare engagement and worsen outcomes for individuals with SUDs.
• Primary care programs, particularly those addressing prescription drug misuse, must actively foster a welcoming environment for patients with SUDs.