Shouting through bullet-proof glass: Some reflections on pharmacotherapy provision in one Australian clinic

Crawford, Sione

doi:10.1016/j.drugpo.2013.07.004

Cited by 37 publications

(29 citation statements)

References 3 publications

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“…Moreover, this would in turn enable them to pursue 'constructive', non-drug using lives characterised by reduced stigma and increased 'normality', 'freedom', and flexibility. Participants' high expectations of depot buprenorphine stand in stark contrast to patients' widely-reported criticisms of the inconvenience, stigma, restrictions and burden of taking oral OAT every day (Crawford, 2013;Fraser & valentine, 2008;Harris & McElrath, 2012;Neale, 2013;Neale et al, 2018b;Radcliffe & Parkes, 2013;Strike et al, 2013). Whilst this suggests that depot buprenorphine could potentially overcome key limitations of traditional OAT formulations, people may have unrealistic beliefs about, and hopes for, new medicinal products, particularly if they have not yet experienced the treatment and yet are eager for treatment or want a rapid solution to complex problems.…”

Section: Discussionmentioning

confidence: 89%

“…Over the years, oral methadone has been the most extensively explored OAT from the patient perspective. Some people prescribed oral methadone have repeatedly described it as a stigmatizing, restrictive and punitive treatment (Crawford, 2013;Harris & McElrath, 2012;Radcliffe & Parkes, 2013;Strike, Millson, Hopkins, & Smith, 2013). Indeed, patients have likened it to a form of social control because it can tie them to strict medication-related rules and monitoring systems, such as urinalysis and daily attendance at services (Chandler et al, 2013;Crawford, 2013;Neale, 2013;Strike et al, 2013;Treloar & valentine, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Some people prescribed oral methadone have repeatedly described it as a stigmatizing, restrictive and punitive treatment (Crawford, 2013;Harris & McElrath, 2012;Radcliffe & Parkes, 2013;Strike, Millson, Hopkins, & Smith, 2013). Indeed, patients have likened it to a form of social control because it can tie them to strict medication-related rules and monitoring systems, such as urinalysis and daily attendance at services (Chandler et al, 2013;Crawford, 2013;Neale, 2013;Strike et al, 2013;Treloar & valentine, 2013). Studies have compared patients' views of oral methadone with oral buprenorphine (Hill et al, 2015;Kelly et al, 2012;Schwartz et al, 2008;White et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Tompkins

Neale

Strang

2019

Journal of Substance Abuse Treatment

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A B S T R A C TAims: Prolonged-release implantable and depot injection formulations of buprenorphine are very recent developments in the treatment of opioid use disorder. Such formulations remove the need for daily dosing and provide patients with sustained concentrations of buprenorphine over a period of weeks or months. We explored opioid users' personal willingness to receive prolonged-release buprenorphine depot injections and factors influencing their interest. Methods: The study took place in London during 2018, before depot buprenorphine was licensed for use in Europe. Thirty-six face-to-face, semi-structured qualitative interviews were conducted with people who were: i) using heroin daily and not receiving any treatment for opioid use (n = 12); or ii) prescribed daily oral buprenorphine (n = 12); or iii) prescribed daily oral methadone (n = 12). Participants were asked about their willingness to receive depot buprenorphine and were encouraged to discuss factors that might alter their opinions. Interview data were analysed following the stages of Iterative Categorization. Findings: Participants expressed a high level of willingness to receive depot buprenorphine. Their views were influenced both positively and negatively by six key features of depot buprenorphine: i) reduced contact with pharmacies and drug treatment services; ii) impact on illicit drug use and recovery; iii) the perceived effectiveness of depot buprenorphine; iv) the duration and dosage of depot buprenorphine injections; v) clinical administration of the depot buprenorphine injection; and vi) potential for side effects associated with the depot buprenorphine injection. Conclusions: Willingness to receive a given medication is complex, individual and changeable. Opioid users seem likely to welcome greater choice and flexibility in respect of opioid agonist medications and appear more likely to accept and adhere to depot buprenorphine if it enables them to reduce their illicit drug use and facilitates their recovery. Research is now needed to assess whether patients' reported willingness to receive depot buprenorphine translates into actual uptake and adherence. (Clinical Guidelines on Drug Misuse and Dependence (Update), 2017).

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Tompkins

Neale

Strang

2019

Journal of Substance Abuse Treatment

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“…The literature on stigma and MMT is primarily qualitative, and documents perceptions of MMT as an extension of substance use stigma into substance use treatment . Among people in substance use treatment and people receiving MMT, experiencing greater substance use stigma has been found to be associated with having more previous treatment experiences, receiving MMT for longer periods of time, engaging in injection (versus non‐injection) drug use and more frequent heroin use .…”

Section: Introductionmentioning

confidence: 99%

Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT‐SMS)

et al. 2019

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Background and aim Experience of stigma towards methadone maintenance treatment (MMT) may be a barrier to the use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct and criterion validity of a theory-based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS) and compared this with the Substance Use Stigma Mechanism Scale (SU-SMS). Design Surveys at the beginning and end of a prospective study together with records of drug use and treatment attendance during that study. Setting Community methadone clinic in the Northeastern USA. Participants Ninety-three participants who were receiving MMT; the average daily methadone dose was 84.8 mg/day (standard deviation = 28.39 mg/day).Measurements The MMT-SMS uses a self-report questionnaire to assess three dimensions reflecting experiences of anticipated (nine items), enacted (nine items) and internalized stigma (seven items) specifically related to receiving MMT. Anticipated and enacted scales include three stigma source subscales (family, employers, health care workers; three items each). Responses are recorded on a five-point Likert-type scale, then averaged to produce the MMT-SMS scale/subscale scores. The SU-SMS is a self-report questionnaire to assess experiences of anticipated, enacted and internalized stigma regarding substance use history. Both scales were administered at the final parent study visit. Other measures included were assessed in the parent study and used to assess life-time and recent MMT (e.g. current MMT dose) and drug use experiences (e.g. past 30-day heroin injection). Findings The MMT-SMS demonstrated good internal reliability (α = 0.806-0.952 for components). Confirmatory factor analysis supported the seven-factor scale structure, distinguishing between experiences of anticipated, enacted and internalized stigma, and anticipated and enacted stigma source subscales (family, employers, health care workers) [root mean square error of approximation (RMSEA) = 0.076, 90% confidence interval (CI) = 0.061-0.090, P-close = 0.003; confirmatory fit index (CFI) = 0.974; Tucker-Lewis index (TLI) = 0.971]. Construct validity helped to distinguish the MMT-SMS from established substance use stigma constructs. Criterion validity observed associations with substance use experiences while on MMT, likely to predict future MMT success. Internalized MMT stigma was uniquely associated with daily MMT dose. Regarding criterion validity: anticipated MMT and enacted substance use stigma were associated with past 30-day heroin injection, MMT stigma uniquely associated with opioid use behaviors while receiving MMT, and substance use stigma broadly associated with injection-related behaviors. Conclusions The Methadone Maintenance Treatment Stigma Mechanisms Scale appears to be a reliable measure of methadone maintenance treatment stigma with robust validity in a sample of people with opioid use disorders receiving methadone maintenance treatment.

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“…In evaluating takeaway policy, any risk associated with overdose must also be weighed up with the possible benefits. Practical benefits for clients include the convenience of accessing treatment, which facilitates participation in family and work, providing a heightened sense of normality [10] and a reduction in the stigmatisation associated with opiod substitution treatment treatment [11], which is a major concern [12–15]. Clients in receipt of takeaways report feeling trusted and appreciate that their privacy has been respected, both important aspects of successful health interventions [16].…”

mentioning

confidence: 99%

Trust, agency and control: Perspectives on methadone takeaway dosing in the context of the Victorian policy review

Berends

Chalmers

Lancaster

2015

Drug and Alcohol Review

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Shouting through bullet-proof glass: Some reflections on pharmacotherapy provision in one Australian clinic

Cited by 37 publications

References 3 publications

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Opioid users' willingness to receive prolonged-release buprenorphine depot injections for opioid use disorder

Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT‐SMS)

Trust, agency and control: Perspectives on methadone takeaway dosing in the context of the Victorian policy review

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