Theme: Social Science & Policy Research Year: 2025
Background:
Hospitals are an important point of access to healthcare for people who use drugs (PWUD); however, many PWUD report negative experiences in hospital settings, including excessive monitoring, inconsistent care, and dismissal of symptoms. While there is extensive research that point to hospitals as “risk environments” from the perspective of PWUD, less is known about how hospital staff and clinicians perceive risks encountered by PWUD.
Methods:
We conducted 11 focus groups between October and December 2017 with 83 personnel from professional groups that have direct interaction with PWUD or whose role affect decision-making within the hospital. Data analysis was guided by the principles of constructivist grounded theory. Applying the risk environment framework, special attention was paid to the ways individual staff and clinician perceptions linked to wider hospital practices and policies.
Results:
Staff and clinicians identified various risks to PWUD during their stay in hospital, not the least of which were linked to hospital and clinical practices that enforced abstinence and the absence of harm reduction services within the hospital. Specifically, our findings highlighted attempts to enforce an informal policy of abstinence, frustration between patients and clinicians, and suboptimal medical care to PWUD. The intertwining of expectations of abstinence with clinical decisions, along with elevated levels of self-directed discharges, was seen as contributing to the widening of health disparities for PWUD.
Conclusion:
As these findings illustrate, expectations of abstinence during admissions are common amongst staff and clinicians and can affect various aspects of a patient’s experience and care in hospital. These findings reveal gaps in supports for PWUD while in hospital and can help clarify future steps for improving acute care experiences and outcomes for PWUD.
Disclosure of Interest Statement:
None
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