TY - JOUR
AU - D. Frank
AU - A. S. Bennett
AU - C. M. Cleland
AU - B. E. Meyerson
AU - D. M. Russell
AU - S. M. Walters
AU - C. Simon
AU - J. D. Scheidell
AU - L. Elliott
A1 - 
AB - INTRODUCTION: Opioid withdrawal is a regular occurrence for many people who use illicit opioids (PWUIO) involving acute physical and psychological pain. Yet, there is very little data on the withdrawal experience of people in methadone maintenance treatment (MMT) and almost none from the patients' experience. Learning more about patients' withdrawal experiences can help to inform policies and practices that are better suited to address withdrawal and may improve patient satisfaction as well as uptake and retention. METHODS: This article is based on 29 semi-structured interviews with people who use illicit opioids who reported recent withdrawal experience. The study conducted interviews remotely via Zoom between April and August 2022 and later transcribed them professionally. The study team then coded data thematically using Atlas.ti, based on a combination of inductive and deductive coding strategies and informed by the literature and study aims. RESULTS: Participants described withdrawal as a significant issue that negatively impacts their treatment experience and increases the likelihood of treatment cessation. Their accounts of withdrawal were complex and often involved multiple factors; however, feeling underdosed and missing clinic dosing hours were seen as important vectors that led to their withdrawal experiences. Importantly, participants framed feeling underdosed and missing clinic dosing hours as institutional problems, resulting primarily from clinic policies, practices, and culture rather than from patients' decisions or individual behavior. Specifically, they cited restricted access to take-home doses, limited hours of operation, and a punitive focus on complete abstinence as factors that made withdrawal difficult to avoid. CONCLUSIONS: Patients' accounts demonstrate a disconnect between providers' focus on promoting complete abstinence and patients, who were often using MMT for more pragmatic reasons that did not include complete abstinence from all drugs. These findings support growing calls for the integration of MMT into the mainstream healthcare system by making it available via prescription from office-based medical settings and dispensed through pharmacies.
AD - Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA. Electronic address: dfrank40@gmail.com.; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; Center for Anti-racism, Social Justice, and Public Health, School of Global Public Health, New York University, New York, NY 10003, USA.; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10003, USA.; Department of Family and Community Medicine, University of Arizona, Tucson, AZ 85711, USA; Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA.; Department of Family and Community Medicine, University of Arizona, Tucson, AZ 85711, USA; Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA; The Kirby Institute, UNSW, Sydney NSW 2052, Australia.; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA.; NC Survivors Union, 1116 Grove St, Greensboro, NC 27403, USA; Whose Corner is it Anyway, 1187 Northampton St., Holyoke, MA, 01040, USA.; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA; Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, USA.; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY 10003, USA.
AN - 39722353
BT - J Subst Use Addict Treat
C5 - Opioids & Substance Use
DA - Mar
DO - 10.1016/j.josat.2024.209616
DP - NLM
ET - 20241223
JF - J Subst Use Addict Treat
LA - eng
N2 - INTRODUCTION: Opioid withdrawal is a regular occurrence for many people who use illicit opioids (PWUIO) involving acute physical and psychological pain. Yet, there is very little data on the withdrawal experience of people in methadone maintenance treatment (MMT) and almost none from the patients' experience. Learning more about patients' withdrawal experiences can help to inform policies and practices that are better suited to address withdrawal and may improve patient satisfaction as well as uptake and retention. METHODS: This article is based on 29 semi-structured interviews with people who use illicit opioids who reported recent withdrawal experience. The study conducted interviews remotely via Zoom between April and August 2022 and later transcribed them professionally. The study team then coded data thematically using Atlas.ti, based on a combination of inductive and deductive coding strategies and informed by the literature and study aims. RESULTS: Participants described withdrawal as a significant issue that negatively impacts their treatment experience and increases the likelihood of treatment cessation. Their accounts of withdrawal were complex and often involved multiple factors; however, feeling underdosed and missing clinic dosing hours were seen as important vectors that led to their withdrawal experiences. Importantly, participants framed feeling underdosed and missing clinic dosing hours as institutional problems, resulting primarily from clinic policies, practices, and culture rather than from patients' decisions or individual behavior. Specifically, they cited restricted access to take-home doses, limited hours of operation, and a punitive focus on complete abstinence as factors that made withdrawal difficult to avoid. CONCLUSIONS: Patients' accounts demonstrate a disconnect between providers' focus on promoting complete abstinence and patients, who were often using MMT for more pragmatic reasons that did not include complete abstinence from all drugs. These findings support growing calls for the integration of MMT into the mainstream healthcare system by making it available via prescription from office-based medical settings and dispensed through pharmacies.
PY - 2025
SN - 2949-8767 (Print); 2949-8759
SP - 209616
ST - "I still can feel the sickness": Withdrawal experiences of people on methadone maintenance treatment
T1 - "I still can feel the sickness": Withdrawal experiences of people on methadone maintenance treatment
T2 - J Subst Use Addict Treat
TI - "I still can feel the sickness": Withdrawal experiences of people on methadone maintenance treatment
U1 - Opioids & Substance Use
U3 - 10.1016/j.josat.2024.209616
VL - 170
VO - 2949-8767 (Print); 2949-8759
Y1 - 2025
ER -