Search results

Improvement in Access to Treatment for People with Alcohol and Drug Related Problems (IATPAD) was a European study that detected barriers and facilitators to accessing treatment for patients with alcohol and drug‐related problems. This article seeks to compare the findings from a qualitative study with patients and staff in Catalunya (Spain).

The paper describes a multi‐centre, qualitative study. A purposive sample of 47 staff, from a randomly selected sample of the three main entrance points to treatment for patients with alcohol and drug problems in Catalunya, were recruited from: Out‐patient General Psychiatry Centres (CSMA); Out‐patient Addiction Centres (CAS); and Primary Care Centres (CAP). In addition, open‐ended responses were collated from 142 additional staff on barriers and facilitators to accessing treatment for patients with alcohol and drug problems and how these barriers could be improved. A total of 25 patients from two CAS were interviewed in‐depth. The framework approach was used to interpret qualitative interviews.

The main barriers and facilitators to accessing treatment identified by staff and patients were patients' motivation, centres' opening hours, staff attitudes, the provision of information about services, and the co‐ordination and integration of different services – mainly the mental health and addiction sectors.

This paper describes and compares the main barriers and facilitators to accessing treatment from both staff and patients' point of view. Recommendations are made in order to improve service accessibility for patients with addiction problems and those with a dual diagnosis.

This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in Barcelona, Spain.

Secondary analysis of a cross‐sectional study of the psychiatric, behavioural and social risk factors for HIV. DSM‐IV disorders were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders; the Composite Abuse Scale assessed intimate partner violence and the Child Maltreatment History Self‐Report assessed childhood physical and sexual abuse.

The odds of experiencing intimate partner violence were 2.42 times greater among those with any depressive disorder (95 per cent CI 1.13, 5.20), over three times greater for those who reported ever attempting suicide (OR 3.20; 95 per cent CI 1.29, 7.94), met criteria for borderline personality disorder (OR 3.05; 95 per cent CI 1.31, 7.11), had been abused in childhood (OR 3.38; 95 per cent CI 1.45, 7.85) or currently lived with a substance user (OR 3.74; 95 per cent CI 1.29, 10.84). In multiple logistic regression, only living with a substance user (OR 3.42; 95 per cent CI 1.08, 10.86) and a history of childhood abuse (OR 2.87; 95 per cent CI 1.05, 7.86) remained significant in the model examining intimate partner violence victimisation.

The small sample size, together with the fact that the study was not originally powered to examine differences in intimate partner violence may have increased the possibility of type II errors.

Histories of psychiatric disorders, intimate partner violence and childhood abuse are common in female substance users in treatment. Research suggests that such histories result in poorer treatment outcomes. Histories of intimate partner violence and childhood abuse should be identified and addressed in substance abuse treatment to enhance treatment outcomes.