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Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys

Author

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  • Victoria Rice Carlisle

    (Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK
    School of Psychological Sciences, University of Bristol, Bristol BS8 1TU, UK)

  • Olivia M. Maynard

    (School of Psychological Sciences, University of Bristol, Bristol BS8 1TU, UK)

  • Darren Bagnall

    (Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK)

  • Matthew Hickman

    (Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK)

  • Jon Shorrock

    (Avon & Wiltshire NHS Mental Health Trust, Specialist Drug and Alcohol Services, Colston Fort, Montague Place, Bristol BS6 5UB, UK)

  • Kyla Thomas

    (Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK)

  • Joanna Kesten

    (Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK
    The National Institute for Health and Care Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK
    The National Institute for Health and Care Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol BS8 1TL, UK)

Abstract

(1) The harm-reduction benefits of opioid agonist treatment (OAT) are well-established; however, the UK government’s emphasis on “recovery” may be contributing to a high proportion of people leaving treatment and low retention rates. We wanted to develop a rich and nuanced understanding of the factors that might influence the treatment journeys of people who use OAT. (2) We explored factors at each level of the socioecological system and considered the ways these interact to influence treatment journeys in OAT. We carried out semi-structured interviews with people who use OAT (n = 12) and service providers (n = 13) and analysed data using reflexive thematic analysis. (3) We developed three themes representing participant perceptions of treatment journeys in OAT. These were: (1) The System is Broken; (2) Power Struggles; and (3) Filling the Void. (4) Conclusions: The data suggest that prioritisation of treatment retention is important to preserve the harm-reduction benefits of OAT. Stigma is a systemic issue which presents multiple barriers to people who use OAT living fulfilling lives. There is an urgent need to develop targeted interventions to address stigma towards people who use OAT.

Suggested Citation

  • Victoria Rice Carlisle & Olivia M. Maynard & Darren Bagnall & Matthew Hickman & Jon Shorrock & Kyla Thomas & Joanna Kesten, 2023. "Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys," IJERPH, MDPI, vol. 20(2), pages 1-20, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1526-:d:1035690
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    References listed on IDEAS

    as
    1. Madden, Erin Fanning, 2019. "Intervention stigma: How medication-assisted treatment marginalizes patients and providers," Social Science & Medicine, Elsevier, vol. 232(C), pages 324-331.
    2. Medina-Perucha, Laura & Scott, Jenny & Chapman, Sarah & Barnett, Julie & Dack, Charlotte & Family, Hannah, 2019. "A qualitative study on intersectional stigma and sexual health among women on opioid substitution treatment in England: Implications for research, policy and practice," Social Science & Medicine, Elsevier, vol. 222(C), pages 315-322.
    Full references (including those not matched with items on IDEAS)

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