Trust, agency and control: Perspectives on methadone takeaway dosing in the context of the <scp>V</scp>ictorian policy review

Berends, Lynda; Chalmers, J. P.; Lancaster, Kari

doi:10.1111/dar.12287

Cited by 4 publications

(3 citation statements)

References 20 publications

(20 reference statements)

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“…Many of these factors appear to be related to less stable patterns of drug use, and are consistent with the perceptions that XR‐buprenorphine may improve treatment adherence and outcomes among those clients who find it difficult to meet current treatment programme requirements and for whom illicit drug use persists. Alternatively, factors such as greater travel distance and fewer unsupervised doses make treatment inconvenient, and policy shifts towards greater restrictions on unsupervised dosing in some jurisdictions (e.g. [28]) may mean that this is an increasing concern for OAT clients.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of extended‐release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

et al. 2020

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Aims To examine perceptions of extended‐release (XR) buprenorphine injections among people who regularly use opioids in Australia. Design Cross‐sectional survey prior to implementation. XR‐buprenorphine was registered in Australia in November 2018. Setting Sydney, Melbourne and Hobart. Participants A total of 402 people who regularly use opioids interviewed December 2017 to March 2018. Measurements Primary outcome concerned the proportion of participants who believed XR‐buprenorphine would be a good treatment option for them, preferred weekly versus monthly injections and perceived advantages/disadvantages of XR‐buprenorphine. Independent variables concerned the demographic characteristics and features of current opioid agonist treatment (OAT; medication‐type, dose, prescriber/dosing setting, unsupervised doses, out‐of‐pocket expenses and travel distance). Findings Sixty‐eight per cent [95% confidence interval (CI) = 63–73%] believed XR‐buprenorphine was a good treatment option for them. They were more likely to report being younger [26–35 versus > 55 years; odds ratio (OR) = 3.16, 95% CI = 1.12–8.89; P = 0.029], being female (OR = 1.67, 95% CI = 1.04–2.69; P = 0.034), < 10 years school education (OR = 1.87, 95% CI = 1.12–3.12; P = 0.016) and past‐month heroin (OR = 1.81, 95% CI = 1.15–2.85; P = 0.006) and methamphetamine use (OR = 1.90, 95% CI = 1.20–3.01; P = 0.006). Fifty‐four per cent reported no preference for weekly versus monthly injections, 7% preferred weekly and 39% preferred monthly. Among OAT recipients (n = 255), believing XR‐buprenorphine was a good treatment option was associated with shorter treatment episodes (1–2 versus ≥ 2 years; OR = 3.93, 95% CI = 1.26–12.22; P = 0.018), fewer unsupervised doses (≤ 8 doses past‐month versus no take‐aways; OR = 0.50; 95% CI = 0.27–0.93; P = 0.028) and longer travel distance (≥ 5 versus < 5 km; OR = 2.10, 95% CI = 1.20–3.65; P = 0.009). Sixty‐nine per cent reported ‘no problems or concerns’ with potential differences in availability, flexibility and location of XR‐buprenorphine. Conclusions Among regular opioid users in Australia, perceptions of extended‐release buprenorphine as a good treatment option are associated with being female, recent illicit drug use and factors relating to the (in)convenience of current opioid agonist treatment.

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Section: Discussionmentioning

confidence: 99%

Perceptions of extended‐release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

et al. 2020

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“…Even though methadone take-home policies are both a matter of considerable debate and a complex area that defies a “one size fits all” approach ( Berends et al, 2015 ), the most restrictive take-home policies are a key barrier to treatment access ( Deering et al, 2011 ; Kourounis et al, 2016 ) and retention ( Pani et al, 1996 ; Rhoades et al, 1998 ). It is unsurprising, therefore, that MMT patients highly value take-home doses ( Fraser, 2006 ).…”

mentioning

confidence: 99%

Increased flexibility in methadone take-home scheduling during the COVID-19 pandemic: Should this practice be incorporated into routine clinical care?

Trujols

Larrabeiti

Sànchez

et al. 2020

Journal of Substance Abuse Treatment

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In the context of the COVID-19 pandemic and the state of emergency that the government of Spain declared, the rapid adaptation of health services is of paramount importance to preserve access to and continuity of service delivery. This research note underscores the importance of ensuring a sufficient quantity of methadone take-home doses for patients on methadone maintenance treatment (MMT) to maximize their adherence to government-imposed lockdown restrictions and social distancing measures designed to curtail the spread of SARS-CoV-2. We evaluate the impact of COVID-19 on take-home medication (number of days provided) in a methadone clinic in Barcelona (Catalonia, Spain). This work conveys that we should consider maintaining the take-home practices that we adopted in response to the pandemic, even after the pandemic has abated.

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“…The provision of methadone and buprenorphine assisted treatment for people experiencing opioid dependence, herein referred to as opioid pharmacotherapy treatment, has been a contentious topic for many years (Ritter & Di Natale, 2005). For decades, there have been concerns that many features of opioid pharmacotherapy treatment policy, such as the restrictions on take-away dose policies, the prohibitive cost of dispensing fees for clients, and restrictive service models, perpetuate experiences of stigma and discrimination and have a negative impact on treatment outcomes (Australian Injecting and Illicit Drug Users League, 2011; Berends et al, 2015; Crawford, 2013; Treloar et al, 2007). Concerted advocacy has been directed towards allowing more flexible treatment delivery models, yet until COVID-19, changing policies and practices has remained politically elusive.…”

Section: Case Studymentioning

confidence: 99%

Established Tables and Emergent Huddles: Exploring the Processes of Participation Associated With the Policy Changes to Opioid Pharmacotherapy Treatment in Australia in the Context of COVID-19

Mellor

Kearnes

Lancaster

et al. 2022

Contemporary Drug Problems

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In this paper we document and analyze emergent participatory processes in drug policy, focusing on the relations between established modes of engagement and emergent participatory formats. We do this through analysis of a case example, attending to policy changes to opioid pharmacotherapy treatment in the context of COVID-19 in Australia. Semistructured interviews ( n = 22) were undertaken between August 2020 and March 2021 with people closely involved in the recent policy changes and discussions surrounding opioid pharmacotherapy treatment in Australia. The analysis of the interview accounts followed work which has forged relational, co-productionist and materialist understandings of participation. Two figures of participation were encountered in the interview accounts: the tables of participation and the huddles of participation. The tables seemingly represented a standardized set of bureaucratic mechanisms for the inclusion of the “voices” of people who use drugs. The huddles emerged as a responsive and less coherent set of ad hoc participatory collectives in the context of rapid policy changes during COVID-19. Instead of viewing emergence as distinct from existing participatory formats, emergence was conceptualized ecologically in this article—that is in relation to established forms of participation. As the institutionally mandated tables served the basis for the emergent huddles of participation in this case study, it demonstrates that even the most foreclosed participatory structures can adapt and be responsive to evolving situations of need, perhaps also in ordinary times and not just in emergency conditions.

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

Cited by 4 publications

References 20 publications

Perceptions of extended‐release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

Perceptions of extended‐release buprenorphine injections for opioid use disorder among people who regularly use opioids in Australia

Increased flexibility in methadone take-home scheduling during the COVID-19 pandemic: Should this practice be incorporated into routine clinical care?

Established Tables and Emergent Huddles: Exploring the Processes of Participation Associated With the Policy Changes to Opioid Pharmacotherapy Treatment in Australia in the Context of COVID-19

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