“Like being put on an ice floe and shoved away”: A qualitative study of the impacts of opioid-related policy changes on people who take opioids

Antoniou, Tony; Ala‐Leppilampi, Kari; Shearer, Dana; Parsons, Janet; Tadrous, Mina; Gomes, Tara

doi:10.1016/j.drugpo.2019.01.015

Cited by 71 publications

(105 citation statements)

References 37 publications

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“…For instance a desire for normality and stability may motivate recovery attempts, yet normal life is also seen as boring (27). Our findings reflect the wider literature on the experience of stigma in substance use disorder more generally (60)(61)(62)(63) and to opioid users specifically (64)(65)(66).…”

Section: [Insert Figure 3 Here]supporting

confidence: 73%

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Carlisle¹,

Maynard²,

Padmanathan³

et al. 2020

Preprint

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Background and Aims Recovery outcomes for opioid substitution treatment are poorer than those for alcohol and other drugs. In order to understand why this is and to synthesise the findings of a large number of qualitative studies, we conducted a systematic review and thematic synthesis to understand facilitators of and barriers to recovery from opioid dependency. Methods Electronic databases (Pubmed, PsychInfo, CINAHL and Embase) were searched. English language studies exploring the views of adult service user and stakeholders with experiences of opioid substitution treatment were considered for inclusion. Included studies were inductively analysed using thematic synthesis. During analysis, the socioecological model was selected as an analytical framework for organising and making links between themes as it captured the complexity of the topic well. ResultsFrom 3646 screened papers, we included 37 studies reporting the views of 1212 staff and service users. Studies highlighted complex interactions between factors influencing recovery across the five levels of the socioecological model (intrapersonal, inter-personal, organisational, community and policy). Early life experiences of trauma were common; lack of support (both psychological and social) was also a recurring theme resulting in feelings of disconnection and isolation. Stigma played a particularly important role in an individual’s capacity to recover from opioid dependency and cut-across all levels of the socioecological model. Conclusions Interventions targeted at the individual level fail to take account of the complexity of recovery within opioid substitution treatment and may ignore the complex socio-political context that service users and services exist within. Stigma permeates all levels of the opioid substitution treatment system; we suggest that addressing this is likely to improve healthcare encounters, help-seeking, increase access to social support and facilitate community reintegration for individuals receiving opioid substitution treatment.

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Section: [Insert Figure 3 Here]supporting

confidence: 73%

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Carlisle¹,

Maynard²,

Padmanathan³

et al. 2020

Preprint

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“…Because the liberal prescribing of opioids was and remains an important contributor to opioid-related harms, including overdose, clinical guidelines have been developed in North America to promote evidenceinformed safe and appropriate opioid prescribing for patients with chronic pain (Busse et al 2017). However, unanticipated consequences of these guidelines have been described, including rapid and potentially harmful tapering practices, dismissal of patients from primary care practices and shifts between the prescribed and non-prescribed environments (Antoniou et al 2019;Dowell et al 2019). In recognition of these phenomena, the Centers for Disease Control and Prevention released a statement in 2019 clarifying the intention of their 2016 recommendations (Dowell et al 2019) and highlighting the serious implications of misapplication of new guidelines and the need for careful communication of how these recommendations should be implemented in clinical practice.…”

Section: Anticipating Unintended Consequencesmentioning

confidence: 99%

Understanding the Implications of a Shifting Opioid Landscape in Ontario

Gomes¹,

Juurlink²

2019

hcq

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North America is currently in the midst of an opioid overdose crisis, leading to changes in drug policy and clinical practice guideline recommendations. Data from Ontario's prescription monitoring program and the Office of the Chief Coroner for Ontario can be used to characterize changing prescription opioid trends and their role in fatal opioid overdoses. A better understanding of historical patterns of opioid use and overdose can help inform a more nuanced drug policy in the future.

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“…However, these studies have been carried out in countries such as the United States or Canada, where the trend of opioid use has been accompanied by an increase in reported opioid abuse and opioid-related death 29 which is a different situation compared to Spain. [30][31][32][33] Considering the potential worries and difficulties associated with the use of opioids, it is very important that patients communicate and relate to health-care providers their experience with opioids in an open and effective manner. However, although the number of individuals living with CP and taking opioids is increasing, to the best of our knowledge, no study has been performed to explore the experiences of patients taking opioid medications in Spain.…”

Section: Introductionmentioning

confidence: 99%

Living with opioids: A qualitative study with patients with chronic low back pain

Sola

Maquibar

Failde

et al. 2020

Health Expectations

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“Like being put on an ice floe and shoved away”: A qualitative study of the impacts of opioid-related policy changes on people who take opioids

Cited by 71 publications

References 37 publications

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Understanding the Implications of a Shifting Opioid Landscape in Ontario

Living with opioids: A qualitative study with patients with chronic low back pain

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