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I don't even want to go to the doctor when I get sick now: Healthcare experiences and discrimination reported by people who use drugs, Arizona 2019.

  • Meyerson, Beth E1
  • Russell, Danielle M2
  • Kichler, Michaela2
  • Atkin, Tyson3
  • Fox, Graeme3
  • Coles, Haley B3
  • 1 Research Professor, Southwest Institute for Research on Women, College of Social & Behavioral Science, Family and Community Medicine, College of Medicine, Institute for LGBT Studies, University of Arizona, 925 N. Tyndall Ave, Suite 203, Tucson, Arizona 85719 USA. Electronic address: [email protected]
  • 2 Arizona State University, 1151 S. Forest Avenue, Tempe, Arizona 85281 USA.
  • 3 Sonoran Prevention Works, 340 E Dunlap Ave, Phoenix, Arizona 85020 USA.
Published Article
The International journal on drug policy
Publication Date
Jul 01, 2021
DOI: 10.1016/j.drugpo.2021.103112
PMID: 33461838


People who use drugs experience severe health inequities created by structural and social barriers related to healthcare access. This includes stigma. To characterize the experience of healthcare access among people who use drugs in Maricopa County, Arizona USA. A 20-item guided survey with quantitative and qualitative items was fielded between October 23-November 5, 2019 among people who use drugs in community locations (public spaces, trap houses, drug copping areas). Surveys were administered face-to-face by community researchers with lived experiences. Survey recruitment included convenience sampling and social referral among respondents. Quantitative items were described and qualitative data were independently coded using an a priori coding scheme including reasons for healthcare seeking and healthcare-related stigma (anticipated, experienced, enacted). Over one-third (39.5%) of the185 person sample did not seek medical care in the past year. Of this group, 34.2% reported that they did not seek needed healthcare because they were afraid of being treated badly by medical providers for using drugs. The three major experiences reported by those seeking healthcare in the past year included 1) medical mistreatment (not addressing the primary medical complaint, providing wrong or inadequate treatment), 2) social mistreatment (disapproval, embarrassment, shaming) and 3) abusive behavior (verbal and physical) by healthcare providers. Efforts should create healthcare social and practice environments that assure appropriate and competent medical care and prohibit healthcare provider mistreatment of people who use drugs. Structural incentives such as healthcare finance, hospital accreditation and medical complaint registration should be considered. Copyright © 2021 Elsevier B.V. All rights reserved.

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