What stops people on long-term opioid substitution from completing treatment?

Drugs and Alcohol Today,Volume 17, Issue 4, Page 232-241, December 2017. Purpose Opioid substitution treatment is effective in reducing harm for the person and society. However, the introduction of the recovery agenda has changed treatment philosophy. Associated targets such as successful treatment completions have introduced new expectations from treatment providers and service users. The purpose of this paper is to provide a service user-centred evaluation of underlying reasons that might prevent them from considering completion of treatment. Design/methodology/approach Ten service users who were stable on opioid substitution treatment for more than five years were interviewed face-to-face using a semi-structured format. Detailed inductive coding and thematic analysis of all transcripts was conducted. Findings Most participants expressed fear of change to their treatment and in particular reduction of the prescribed medication, due to past traumatic withdrawal experience, fear of relapse, fear of negative impact on their mental and physical health. Nevertheless all were optimistic about their future lives and were hoping to be able to complete their treatment at some point. A three-month follow-up revealed little change, with most participants not considering changing their medication dose in the future. Practical implications It could be argued that treatment providers, instead of focussing their efforts on stable service users in promoting treatment exit, should focus...

Source: Drugs and Alcohol Today - November 29, 2017 Category: Addiction Source Type: research