Professional stigma towards clients with methamphetamine use disorder – a qualitative study

ABSTRACT

Background:

Methamphetamine use disorder (MUD) is associated with poor health outcomes. Pharmacists play a role in delivery of substance use treatment, with several studies having examined their attitudes to people with opioid use disorder, but little is known about their attitude towards people with MUD. This study aimed to explore pharmacists’ perspectives on the provision of services to clients with MUD.

Methods:

A convenience sampling strategy was used to recruit community pharmacists across Sydney, Australia. Semi structured interviews examined views and ideas of pharmacists surrounding the treatment and management of MUD, followed by coding of transcribed interview data by all members of the research team.

Results:

Nineteen pharmacists completed the interviews. The main theme identified was stigma held by healthcare professionals. The almost unanimous perception amongst pharmacists was fear and apprehension towards people with MUD, including underlying assumptions of criminality, misinformation regarding people with MUD, and lack of education and knowledge surrounding MUD.

Conclusion:

A substantial amount of stigma towards people with MUD was found in this study. Negative attitudes by healthcare professionals can perpetuate healthcare disparities and impede the accessibility of future treatment programs for people with MUD. Appropriate educational interventions on MUD for pharmacists are needed.

KEYWORDS:

• Methamphetamine use disorder
• substance use disorders
• qualitative studies
• pharmacy
• stigma

Acknowledgements

AM: PhD candidate who undertook the main tasks relating to recruitment, data collection, analysis and writing up of manuscript; CD: co-supervisor of the project and major contributor to conceptualisation of the research method, analysis and editing/reporting of results; BC: main supervisor and major contributor to acquiring ethics approval, conceptualisation, analysis and writing up of manuscript. Each author certifies that their contribution to this work meets the standards of the International Committee of Medical Journal Editors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Ali Makki

Ali Makki is a researcher and PhD candidate at The University of Sydney. His thesis is titled: Exploring perspectives on the role of pharmacists in the provision of services to clients with a methamphetamine use disorder. He is also a registered pharmacist with a Bachelor of Medical Science degree and a Master of Pharmacy degree. He has extensive experience working as a registered pharmacist across the community and hospital Pharmacy sector, with recent focus but not confined to drug and alcohol services.

Carolyn Day

Professor Carolyn Day is from the Specialty of Addiction Medicine in Sydney Medical School and has more than two decades experience working directly with people with substance use disorders. Professor Day is the Illicit Drug Theme lead for the Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, an Honorary Research Associate with the Sydney Uniting Medically Supervised Injecting Centre and a member of the Sydney Local Health District Harm Minimisation Program Steering Committee. She is also the Vice-President of the NSW Alcohol and Drug Foundation which operates Kathleen York House, an awarding winning non-government residential rehabilitation treatment service for women with substance use disorders and their children. Professor Day has co-authored more than 210 publications (138 peer-reviewed) and is an editor for the international peer-reviewed Journal Drug and Alcohol Review. She developed the first Australian guidelines on interviewing people who inject drugs for the National Drug and Alcohol Research Centre, which have been adopted by numerous organisations nationally and internationally and published an invited editorial on the topic for the leading drug and alcohol peer-reviewed journal Addiction. She is also the current academic lead for the Edith Collins Centre consumer representation working group.

Betty B. Chaar

Dr Betty B. Chaar is an Associate Professor and researcher in Pharmacy Practice at the School of Pharmacy. She holds a Master's degree in Health Law and her PhD is about professional ethics in pharmacy. She has many years' experience in community pharmacy, hospital pharmacy and academia upon which she bases her research. Her research focusses on pharmacy practice, in particular as it relates to ethical practice and implementation of standards of practice. This includes but is not restricted to, the role of the pharmacist in addiction and harm minimisation; medicines shortages, complementary medicines; conscientious objection in the context of euthanasia and abortion; medicines in professional sports; the teaching of ethics in pharmacy in Australian curricula, and other contemporary issues. Betty is a Fellow of the International Pharmaceutical Federation, Chair of the FIP Ethics Expert Group and longstanding member of the FIP Congress Program Committee. She has been Chair of the Family Planning NSW Human Research Ethics Committee for 10 years.