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Interest in Getting Help to Reduce or Stop Substance Use Among Syringe Exchange Clients Who Use Opioids

Frost, Madeline C., MPH; Williams, Emily C., PhD, MPH; Kingston, Susan, BS; Banta-Green, Caleb J., PhD, MPH, MSW

doi: 10.1097/ADM.0000000000000426
Original Research

Objectives: Opioid use is a growing problem in the United States. Despite existence of effective treatments (eg, opioid agonist medication), most people with opioid use disorder do not receive treatment. Increasing treatment receipt is an essential component of the response to the opioid crisis. We examined factors associated with interest in getting help to reduce or stop substance use among syringe exchange program (SEP) clients who reported using opioids.

Methods: Surveys were administered at 17 SEPs across Washington State during 2015; 436 respondents who reported recent opioid use and not receiving current treatment were eligible for this analysis. Multivariable logistic regression was conducted to examine factors associated with being somewhat or very interested in getting help, including sociodemographic characteristics, substance use behaviors and outcomes, and use of health care services.

Results: Most participants reported interest in getting help (77.5%). Factors positively associated with interest included female gender (adjusted odds ratio [AOR] = 1.79; 95% confidence interval [CI]: 1.03, 3.11), having an abscess (AOR = 1.87; 95% CI: 1.02, 3.40), and having received treatment (AOR = 4.83; 95% CI: 1.77, 13.14) or other services (AOR = 3.01; 95% CI: 1.06, 8.54) in the past year. Recent methamphetamine use was negatively associated with interest in getting help (AOR = 0.49; 95% CI: 0.26, 0.91).

Conclusions: In this survey of SEP clients, interest in getting help to reduce or stop substance use was prevalent and varied across subpopulations of persons using opioids. Findings point to SEPs as an important venue for treatment engagement, and suggest subgroups who may be targeted for engagement interventions.

Department of Health Services, University of Washington School of Public Health (MCF, ECW, CJB-G); Alcohol and Drug Abuse Institute, University of Washington (SK, CJB-G); Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle WA (MCF, ECW).

Send correspondence to Caleb J. Banta-Green, PhD, MPH, MSW, Alcohol and Drug Abuse Institute, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 120, Seattle, WA 98105. E-mail:

Received 17 January, 2018

Accepted 11 May, 2018

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Dr. Banta-Green and Ms. Kingston received funding from the Washington State Department of Social and Health Services, Division of Behavioral Health and Recovery to support their effort on this project. Dr. Williams is supported by a Career Development Award from VA HSR&D (CDA 12-276). Funders had no role in study design, data analysis, or the decision to submit for publication. Views expressed in this article are those of the authors and do not necessarily represent the views of the University of Washington, Alcohol and Drug Abuse Institute, Department of Veterans Affairs, or the Washington State Department of Social and Health Services. Thank you to the SEP staff and clients who contributed their time and expertise during the collection of these data.

The authors report no conflicts of interest.

© 2018 American Society of Addiction Medicine