The 'black box' of treatment : Patients’ perspective on what works in opioid maintenance treatment for opioid dependence
| Autor: | Teresa Madeira da Silva, Fredrik B. Andersson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Quality of life
medicine.medical_specialty Social Work media_common.quotation_subject 030508 substance abuse Relapse prevention Psykiatri Social group Patient perspective Opioid dependence 03 medical and health sciences Interpersonal relationship 0302 clinical medicine Quality of life (healthcare) Social pathology. Social and public welfare. Criminology medicine Opiate Substitution Treatment Secondary Prevention Humans 030212 general & internal medicine Psychiatry Beroendelära HV1-9960 Substance use disorders media_common Socialt arbete Motivation Opioid maintenance treatment Health Policy Research Substance Abuse Social environment Tvärvetenskapliga studier inom samhällsvetenskap Abstinence Opioid-Related Disorders patient perspective Analgesics Opioid Psychiatry and Mental health Health psychology Life course approach Public aspects of medicine RA1-1270 Social Sciences Interdisciplinary 0305 other medical science Psychology |
| Zdroj: | Substance Abuse Treatment, Prevention, and Policy, Vol 16, Iss 1, Pp 1-15 (2021) Substance Abuse Treatment, Prevention, and Policy |
| Popis: | Background A lack of conceptual modeling of how the components of opioid maintenance treatment (OMT) for opioid dependence (OD) work causes it to occasionally be labeled the “black-box” of treatment. This study had a two-fold objective: First, to analyze which factors related to OMT for OD contribute to the abstinence of problematic use of non-prescribed opioids and sustain recovery, from the patients’ perspective; second, to understand which changes OMT produced in the individuals’ lives might significantly contribute to relapse prevention. Methods We used qualitative methods of design, inquiry, and analysis from a convenience sample of 19 individuals in a Swedish treatment setting. Results All the participants reported previous cycles of problematic use of non-prescribed opioids and other non-prescribed psychoactive substances, treatment, abstinence, recovery, and relapse before starting the current OMT program. During the pre-treatment stage, specific events, internal processes, and social environments enhanced motivation toward abstinence and seeking treatment. During the treatment stage, participants perceived the quality of the human relationships established with primary social groups as important as medication and the individual plan of care in sustaining recovery. From the participants’ perspective, OMT was a turning point in their life course, allowing them a sense of self-fulfillment and the reconstruction of personal and social identity. However, they still struggled with the stigmatization produced by a society that values abstinence-oriented over medication-assisted treatments. Conclusion OMT is not an isolated event in individuals’ lives but rather a process occurring within a specific social context. Structural factors and the sense of acceptance and belonging are essential in supporting the transformation. Treatment achievements and the risk for relapse vary over time, so the objectives of the treatment plan must account for characteristics of the pre-treatment stage and the availability and capacity of individuals to restructure their social network, besides the opioid maintenance treatment and institutional social care. |
| Databáze: | OpenAIRE |
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