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

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  • 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
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    References listed on IDEAS

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    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.
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    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.

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