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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
Open accessAbstract
Background People who use drugs experience severe health inequities created by structural and social barriers related to healthcare access. This includes stigma. Objective To characterize the experience of healthcare access among people who use drugs in Maricopa County, Arizona USA. Methods 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). Results 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. Conclusions 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.
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Patients labeled as drug seekers by clinicians in previous visits may hesitate to return to the hospital due to the fear of being mistreated and misunderstood.
“patients labeled as drug seekers by clinicians in previous visits may hesitate to return to the hospital due to the fear of being mistreated and misunderstood [66].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [66]
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Self-citation
Metadata
- Authors
- Meyerson, B. E., Russell, D. M., Kichler, M., Atkin, T., Fox, G., & Coles, H. B.
- Affiliations
- University of Arizona (US)
- Arizona State University (US)
- Corresponding author
- Meyerson, Beth E.
- Venue
- International Journal of Drug Policy
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 93
- Pages
- 103112
- ISSN
- 0955-3959 (ISSN-L)
- OpenAlex
- W3119166117
- Cited by
- 99
- References
- 43
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 25 · 2023: 23 · 2022: 16 · 2021: 7
- FWCI
- 12.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- International Journal of Drug Policy (publishedVersion)
- PubMed (publishedVersion)
- UA Campus Repository (The University of Arizona) (acceptedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Robert Wood Johnson Foundation
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Keywords
- drug users, health care access, health care discrimination, stigma, health disparities, healthcare seeking, Maricopa County
- MeSH terms
- Arizona, Pharmaceutical Preparations, Health Personnel, Health Services Accessibility, Humans, Social Stigma
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