1. The dynamics of more-than-human care in depot buprenorphine treatment: A new materialist analysis of Australian patients' experiences.
- Author
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Barnett A, Pienaar K, Lubman DI, Arunogiri S, Phan V, Hayes V, Lintzeris N, and Savic M
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Australia, Qualitative Research, Narcotic Antagonists administration & dosage, Interviews as Topic, Methadone administration & dosage, Buprenorphine administration & dosage, Opioid-Related Disorders drug therapy, Opiate Substitution Treatment, Delayed-Action Preparations
- Abstract
Background: Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients' experiences of depot buprenorphine treatment, including how it feels within the body, experiences of dosing cycles across time, and how this form of treatment relies on wider ecologies of care beyond the clinical encounter., Methods: Participants were recruited from sites in Sydney, regional New South Wales, and Melbourne, Victoria, Australia. Thirty participants (16 men, 14 women) participated in semi-structured interviews. Participants had histories of both heroin and prescription opioid consumption, and opioid agonist therapy including daily dosing of buprenorphine and methadone., Results: Our analysis illuminates: (1) how patients' expectations and concerns about treatment are linked to past embodied experiences of withdrawal and uncertainty about the effectiveness of depot buprenorphine; (2) the diverse meanings patients attribute to the depot buprenorphine substrate 'under the skin'; and, (3) how depot buprenorphine is embedded within wider ecologies of care, such as counselling and social supports., Conclusion: Our analysis destabilises commonplace assumptions about a linear, causal relationship between the pharmacological action of depot buprenorphine and experiences of treatment. Instead, it highlights patients' variable experiences of depot buprenorphine, tracing the everyday practices, embodied feelings, expectations and wider networks of care that shape patient experiences. We conclude with some reflections on the implications of our analysis for alcohol and other drug treatment, specifically how they might inform the design of client education materials and care., Competing Interests: Declaration of competing interest ROLE OF FUNDING SOURCE This research was supported by funding from Camurus AB. SA is supported by a National Health and Medical Research Council Investigator Grant (GNT2008193). SA has received honoraria for advisory board attendance from Camurus and Indivior, and speaker honoraria from Camurus, Indivior, Gilead, Janssen and Servier unrelated to this work. VH has received funding from Camurus AB and ViiV Healthcare to provide training. NL has received honoraria for attendance on Advisory Boards for Indivior, Mundipharma and Chiesi Pharmaceuticals, and has received research funding from Camurus AB for unrelated research. DL has previously received speaking honoraria from AstraZeneca, Camurus, Indivior, Janssen, Servier, Shire and Lundbeck and has provided consultancy advice to Lundbeck and Indivior. DL is supported by a NHMRC Investigator grant (1196892). Other than support received from Camurus AB for this project, AB, MS, KP and VP have no funding disclosures to declare., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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