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Article

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

by
Victoria Rice Carlisle
1,2,*,
Olivia M. Maynard
2,
Darren Bagnall
1,
Matthew Hickman
1,
Jon Shorrock
3,
Kyla Thomas
1 and
Joanna Kesten
1,4,5
1
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TL, UK
2
School of Psychological Sciences, University of Bristol, Bristol BS8 1TU, UK
3
Avon & Wiltshire NHS Mental Health Trust, Specialist Drug and Alcohol Services, Colston Fort, Montague Place, Bristol BS6 5UB, UK
4
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
5
The National Institute for Health and Care Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol BS8 1TL, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(2), 1526; https://doi.org/10.3390/ijerph20021526
Submission received: 30 November 2022 / Revised: 9 January 2023 / Accepted: 11 January 2023 / Published: 14 January 2023
(This article belongs to the Special Issue Substance Use, Stigma and Social Harm)
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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.
Keywords: opioid agonist treatment; methadone; stigma; socioecological model; drug treatment; qualitative opioid agonist treatment; methadone; stigma; socioecological model; drug treatment; qualitative

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MDPI and ACS Style

Carlisle, V.R.; Maynard, O.M.; Bagnall, D.; Hickman, M.; Shorrock, J.; Thomas, K.; Kesten, J. Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys. Int. J. Environ. Res. Public Health 2023, 20, 1526. https://doi.org/10.3390/ijerph20021526

AMA Style

Carlisle VR, Maynard OM, Bagnall D, Hickman M, Shorrock J, Thomas K, Kesten J. Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys. International Journal of Environmental Research and Public Health. 2023; 20(2):1526. https://doi.org/10.3390/ijerph20021526

Chicago/Turabian Style

Carlisle, Victoria Rice, Olivia M. Maynard, Darren Bagnall, Matthew Hickman, Jon Shorrock, Kyla Thomas, and Joanna Kesten. 2023. "Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys" International Journal of Environmental Research and Public Health 20, no. 2: 1526. https://doi.org/10.3390/ijerph20021526

APA Style

Carlisle, V. R., Maynard, O. M., Bagnall, D., Hickman, M., Shorrock, J., Thomas, K., & Kesten, J. (2023). Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys. International Journal of Environmental Research and Public Health, 20(2), 1526. https://doi.org/10.3390/ijerph20021526

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