Home > Experiences of people engaged in long-term methadone maintenance treatment.

Carew, Anne Marie (2019) Experiences of people engaged in long-term methadone maintenance treatment. Drugnet Ireland , Issue 70, Summer 2019 , p. 17.

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On 10 December 2018, the Dun Laoghaire Rathdown Drug and Alcohol Task Force (DLRDATF) launched their report, ‘Just maintaining the status quo’? The experiences of long-term participants in methadone maintenance treatment.1 The report documents the findings of a qualitative study examining the experiences of people engaged in long-term methadone maintenance treatment in the Dun Laoghaire Rathdown area of South Dublin. 

 

This is the first Irish study to specifically examine the experiences of individuals who are engaged in long-term methadone maintenance treatment. The study was conducted by a team of researchers from Trinity College Dublin, led by Dr Paula Mayock of the School of Social Work and Social Policy. The main study objective was to examine the lived experiences of people receiving methadone treatment, their social relationships, health, and social care needs. 

 

The study examined the experiences and perspectives of 25 people (16 male, 9 female) who first accessed methadone treatment a minimum of 10 years ago, and who reported at least one episode of opioid substitution treatment since first accessing treatment. Study participants were recruited through services located in the Dun Laoghaire Rathdown area, including specialist addiction clinics, community and voluntary addiction services, primary care services, and supported temporary accommodation services. Interviews were conducted between August 2017 and February 2018.

The average age of research participants was 43 years. Almost one-third (32%) of participants were aged 35–39 years; 56% were aged 10–49 years; and the remaining 12% were aged 50 years or older. Almost two-thirds of participants (64%) had first accessed methadone maintenance treatment more than 20 years previously. 

Key findings

  • The majority of participants reported that methadone maintenance treatment had positively impacted at least one aspect of their lives. The most commonly reported benefit was stability and normality, with improved capacity to fulfil roles as parents, family members, and friends.
  • The average age of first drug use was 14 years of age, while the average age of first heroin use was 19 years of age.
  • Levels of educational attainment were low among participants, with one in four (24%) having no educational qualifications and more than one-half (52%) not progressing beyond Junior Certificate level.
  • Almost one-third of participants (32%) were homeless or living in unstable accommodation at the time of interview. More than one-half of the study participants (56%) had experienced homelessness at some point in their lives.
  • Mental health problems, including depression, were widely reported among study participants.
  • Many reported having chronic illnesses, including hepatitis C, liver cirrhosis, and a range of respiratory, renal, and coronary diseases.
  • Negative experiences were reported by many, including negative interactions with treatment services and health professionals, and little autonomy in their treatment progression, particularly in relation to long-term rehabilitation planning.
  • Stigma was a dominant experience reported by study participants. Stigma was reported on many levels, including within treatment settings and within the communities where people resided. Participants reported feeling stereotyped and disrespected within their treatment setting, and many reported attempting to conceal their methadone use and clinic attendance from family and friends. Other forms of stigma related to being an older person in treatment and fear of judgement or rejection due to continued engagement in treatment.
  • Participants perceived themselves as stigmatised health-service users, with many feeling excluded from employment and having little prospect of further education.
  • Levels of social reintegration among participants were reported as extremely low. The majority reported being unemployed with no realistic prospect of employment.
  • Most participants did not have access to the economic, social or personal resources needed to support and sustain recovery.

Conclusions

The report shows the complexity and characteristics of people who are long-term participants in methadone maintenance treatment. The authors highlight issues experienced by this group, including physical and mental health problems, isolation, social exclusion, and loneliness. The authors note that age combined with long-term drug use and treatment careers indicate that this group have many challenging health, social, and economic needs. The report also highlights that, although methadone treatment had a positive impact on the lives of the study participants, multifaceted and multidisciplinary supports, including education, training, housing and family welfare, are needed in order to achieve social reintegration.

 

1    Mayock P, Butler S and Hoey D (2018) ‘Just maintaining the status quo’? The experiences of long-term participants in methadone maintenance treatment. Dublin: Dun Laoghaire Rathdown Drug and Alcohol Task Force. https://www.drugsandalcohol.ie/30063/

Item Type:Article
Issue Title:Issue 70, Summer 2019
Date:September 2019
Page Range:p. 17
Publisher:Health Research Board
Volume:Issue 70, Summer 2019
EndNote:View
Subjects:B Substances > Opioids (opiates) > Opioid product > Methadone
HJ Treatment method > Substance disorder treatment method > Substance replacement method (substitution) > Methadone maintenance
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
J Health care, prevention and rehabilitation > Treatment and maintenance > Patient attitude toward treatment
VA Geographic area > Europe > Ireland

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