IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v64y2007i9p1937-1947.html
   My bibliography  Save this article

Agency and dependency within treatment: Drug treatment clients negotiating methadone and antidepressants

Author

Listed:
  • Holt, Martin

Abstract

This paper explores how drug treatment clients exercise agency while finding their ability to act curtailed by the strictures of treatment itself. Drawing on qualitative interviews with 77 male and female drug treatment clients collected in an Australian study of drug treatment and mental health, the experience of methadone maintenance treatment (MMT) and that of commonly prescribed medications for depression (antidepressants) are examined. The ways that clients engage with MMT and antidepressants are detailed, illustrating how both types of treatment can make clients feel dependent, but can also motivate clients to modify their treatment regimens. These modifications are "tactical" responses generated within the constraints of treatment regulations and can also be against clinical recommendations e.g. stopping treatment. Rather than seeing this as "non-compliance", it is suggested that the negotiation of treatment is an inevitable response of clients trying to adapt to imperfect treatment conditions, who may have understandable anxieties about taking medication. The ways in which treatment providers might better acknowledge the capacities of MMT clients to engage with or modify treatment are discussed, as is the need to acknowledge drug treatment clients' anxieties about dependency and pharmaceutical drugs.

Suggested Citation

  • Holt, Martin, 2007. "Agency and dependency within treatment: Drug treatment clients negotiating methadone and antidepressants," Social Science & Medicine, Elsevier, vol. 64(9), pages 1937-1947, May.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:9:p:1937-1947
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(07)00023-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Moore, David & Fraser, Suzanne, 2006. "Putting at risk what we know: Reflecting on the drug-using subject in harm reduction and its political implications," Social Science & Medicine, Elsevier, vol. 62(12), pages 3035-3047, June.
    2. Conrad, Peter, 1985. "The meaning of medications: Another look at compliance," Social Science & Medicine, Elsevier, vol. 20(1), pages 29-37, January.
    3. Pound, Pandora & Britten, Nicky & Morgan, Myfanwy & Yardley, Lucy & Pope, Catherine & Daker-White, Gavin & Campbell, Rona, 2005. "Resisting medicines: a synthesis of qualitative studies of medicine taking," Social Science & Medicine, Elsevier, vol. 61(1), pages 133-155, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Schweda, Mark & Pfaller, Larissa, 2014. "Colonization of later life? Laypersons' and users' agency regarding anti-aging medicine in Germany," Social Science & Medicine, Elsevier, vol. 118(C), pages 159-165.
    2. Ridge, Damien & Kokanovic, Renata & Broom, Alex & Kirkpatrick, Susan & Anderson, Claire & Tanner, Claire, 2015. "“My dirty little habit”: Patient constructions of antidepressant use and the ‘crisis’ of legitimacy," Social Science & Medicine, Elsevier, vol. 146(C), pages 53-61.
    3. McNeil, Ryan & Kerr, Thomas & Anderson, Solanna & Maher, Lisa & Keewatin, Chereece & Milloy, M.J. & Wood, Evan & Small, Will, 2015. "Negotiating structural vulnerability following regulatory changes to a provincial methadone program in vancouver, canada: A qualitative study," Social Science & Medicine, Elsevier, vol. 133(C), pages 168-176.
    4. Malpass, Alice & Shaw, Alison & Sharp, Debbie & Walter, Fiona & Feder, Gene & Ridd, Matthew & Kessler, David, 2009. ""Medication career" or "Moral career"? The two sides of managing antidepressants: A meta-ethnography of patients' experience of antidepressants," Social Science & Medicine, Elsevier, vol. 68(1), pages 154-168, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gibson, Grant, 2016. "‘Signposts on the journey’; medication adherence and the lived body in men with Parkinson's disease," Social Science & Medicine, Elsevier, vol. 152(C), pages 27-34.
    2. Berry, Brandon & Apesoa-Varano, Ester Carolina, 2017. "Medication takeovers: Covert druggings and behavioral control in Alzheimer's," Social Science & Medicine, Elsevier, vol. 188(C), pages 51-59.
    3. Buus, Niels, 2014. "Adherence to anti-depressant medication: A medicine-taking career," Social Science & Medicine, Elsevier, vol. 123(C), pages 105-113.
    4. Webster, Michelle, 2017. "Similarities and differences in the meanings children and their parents attach to epilepsy medications," Social Science & Medicine, Elsevier, vol. 177(C), pages 190-197.
    5. Timmermans, Stefan & Tietbohl, Caroline, 2018. "Fifty years of sociological leadership at Social Science and Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 209-215.
    6. Zhou, Amy, 2016. "The uncertainty of treatment: Women's use of HIV treatment as prevention in Malawi," Social Science & Medicine, Elsevier, vol. 158(C), pages 52-60.
    7. Williams, Kevin Frank, 2007. "Re-examining 'professionalism' in pharmacy: A South African perspective," Social Science & Medicine, Elsevier, vol. 64(6), pages 1285-1296, March.
    8. Allison Williams & Jac Kee Low & Elizabeth Manias & Kimberley Crawford, 2016. "The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(15-16), pages 2251-2261, August.
    9. Rebecca J Bartlett Ellis & Janet L Welch, 2017. "Medication‐taking behaviours in chronic kidney disease with multiple chronic conditions: a meta‐ethnographic synthesis of qualitative studies," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(5-6), pages 586-598, March.
    10. Dew, Kevin & Norris, Pauline & Gabe, Jonathan & Chamberlain, Kerry & Hodgetts, Darrin, 2015. "Moral discourses and pharmaceuticalised governance in households," Social Science & Medicine, Elsevier, vol. 131(C), pages 272-279.
    11. Ezell, Jerel M. & Walters, Suzan & Friedman, Samuel R. & Bolinski, Rebecca & Jenkins, Wiley D. & Schneider, John & Link, Bruce & Pho, Mai T., 2021. "Stigmatize the use, not the user? Attitudes on opioid use, drug injection, treatment, and overdose prevention in rural communities," Social Science & Medicine, Elsevier, vol. 268(C).
    12. Karine Lamiraud & Pierre‐Yves Geoffard, 2007. "Therapeutic non‐adherence: a rational behavior revealing patient preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1185-1204, November.
    13. Ridge, Damien & Kokanovic, Renata & Broom, Alex & Kirkpatrick, Susan & Anderson, Claire & Tanner, Claire, 2015. "“My dirty little habit”: Patient constructions of antidepressant use and the ‘crisis’ of legitimacy," Social Science & Medicine, Elsevier, vol. 146(C), pages 53-61.
    14. Ceuterick, Melissa & Vandebroek, Ina, 2017. "Identity in a medicine cabinet: Discursive positions of Andean migrants towards their use of herbal remedies in the United Kingdom," Social Science & Medicine, Elsevier, vol. 177(C), pages 43-51.
    15. Klein, Linda A. & Ritchie, Jan E. & Nathan, Sally & Wutzke, Sonia, 2014. "An explanatory model of peer education within a complex medicines information exchange setting," Social Science & Medicine, Elsevier, vol. 111(C), pages 101-109.
    16. Lien, Hsien-Ming & Lu, Mingshan & Albert Ma, Ching-To & McGuire, Thomas G., 2010. "Progress and compliance in alcohol abuse treatment," Journal of Health Economics, Elsevier, vol. 29(2), pages 213-225, March.
    17. Goldsmith, Laurie J. & Kolhatkar, Ashra & Popowich, Dominic & Holbrook, Anne M. & Morgan, Steven G. & Law, Michael R., 2017. "Understanding the patient experience of cost-related non-adherence to prescription medications through typology development and application," Social Science & Medicine, Elsevier, vol. 194(C), pages 51-59.
    18. Williams, Brian & Steven, Karen & Sullivan, Frank M., 2011. "Tacit and transitionary: An exploration of patients' and primary care health professionals' goals in relation to asthma," Social Science & Medicine, Elsevier, vol. 72(8), pages 1359-1366, April.
    19. Fleming, Taylor & Collins, Alexandra B. & Boyd, Jade & Knight, Kelly R. & McNeil, Ryan, 2023. "“It's no foundation, there's no stabilization, you're just scattered”: A qualitative study of the institutional circuit of recently-evicted people who use drugs," Social Science & Medicine, Elsevier, vol. 324(C).
    20. Scott, Sydney E. & Landy, Justin F., 2023. "“Good people don’t need medication”: How moral character beliefs affect medical decision making," Organizational Behavior and Human Decision Processes, Elsevier, vol. 175(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:64:y:2007:i:9:p:1937-1947. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.