2025-06-12 –, BS 3.14 - 60 cap.
Background
People living with disability (PWD) are much more likely to use intravenous drugs than those without a disability. Yet, while Medication for Opioid Use Disorder has been shown to reduce drug-related harms, little is known about the lived experiences of this marginalized population and the barriers they face to entering and remaining in MOUD treatment.
Design
We conducted 25 qualitative interviews with PWD/PWID living in San Juan, Puerto Rico, a US territory. Participants with self-reported visual, hearing, cognitive, mobility, or other impairments with a history of intravenous drug use were recruited. This study collected treatment trajectories illustrating the individual, communal, and structural barriers this population faced to access treatment and the resources they could mobilize to receive care.
Results
Findings show that a majority of PWD/PWID do not self-identify as living with a disability despite having an impairment and that accommodations for this population are sorely lacking in MOUD clinics in Puerto Rico. Distance to MOUD clinics, poor transportation, and physical barriers such as lack of ramps erect more barriers, along with the compounded stigma of disability and intravenous drug use. Support networks included kin and others offering car rides or escorting patients to the clinics. Findings show that active PWID with a disability are less likely to receive MOUD than those who are not currently injecting.
Conclusion
More resources should be allocated to limit the barriers particularly minoritized populations of PWD/PWID face in accessing MOUD. Reducing barriers improves treatment outcomes and is a social justice issue.
Roberto Abadie Ph. D. Assistant Professor. University of Wisconsin-Madison. USA
As a trained medical anthropologist, my research focuses on how health disparities, particularly class, gender, race, and ethnicity, contribute to producing and reproducing health inequalities in marginalized populations. I have conducted extensive research on health disparities, HIV/HCV, and overdose risks among people who inject drugs in Puerto Rico, a US territory. I am interested in understanding the everyday lives of people who inject drugs (PWID) and how colonialism, poverty, dispossession, and racism shape their injection behaviors, HIV/HCV and overdose risk, and other drug-related harms.