Table 3.

Healthcare utilization - Barriers and facilitators

Barriers

Substance use disorder  ➢ Functionality  ➢ Cognition  ➢ (De-)prioritization  ➢ Self-medication

Fear of stigma  ➢ Discrimination  ➢ Humiliation  ➢ Mistrust  ➢ Judged/Labelled  ➢ Unprofessional behavior medical staff: focusing on drug use instead of problem presented. Not listening/taking patients seriously. Lack of knowledge and understanding.

Self-stigma  ➢ Shame  ➢ Blame (oneself)  ➢ Not being worthy  ➢ Situation caused by oneself

Difficulties navigating throughout the Healthcare System  ➢ Not knowing where to go/whom to contact  ➢ System not cohesive  ➢ Lack of information  ➢ Difficulties keeping appointments

Facilitators

Cohesive healthcare  ➢ On-site  ➢ Convenience - Going there anyway (to OST clinic)  ➢ Support incl. Booking appointment/ reminding  ➢ Trust - Safe space  ➢ Being listened to /taken seriously. Being someone who matters  ➢ Dedicated, professional staff