Date of Award

Spring 2016

Document Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Mary Lindsey Smith


barriers, access, opioid, detoxification, gender, women, Donabedien, Muskie School of Public Service


The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, and categorized as pertaining to availability, affordability, accommodation, accessibility, and acceptability. Categories were compartmentalized in the barrier model by using a framework of structure, process, and outcome, which are Avedis Donabedien’s triad of healthcare quality. The results of the study demonstrate that the Milestone Foundation acute opioid detoxification program anticipates and mitigates many of the potential barriers to women, by counteracting deficiencies of specific components in the barrier model with strengths from other components in the category, or with linked components in an associated category. Barriers that prevent women from requesting treatment may still present a problem. Further revisions may be necessary as the prevalence of opioid use disorder in women continue.



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