Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-20T01:27:59.169Z Has data issue: false hasContentIssue false
  • English
  • Français

Methadone Treatment in Irish General Practice: Voices of Service Users

Published online by Cambridge University Press:  13 June 2014

Linda Latham
Linda Latham*
Affiliation:
Thomas Court Primary Care Centre, 1 St Catherine's Lane West, Dublin 8
*
Correspondence Email: drlinda.latham@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

This study sets out to make a meaningful and useful contribution to the discussion surrounding the treatment of heroin addiction in Ireland. The study took place in nine urban general practices in Dublin city. Twenty five service users were interviewed in-depth. A phenomenological approach drawing on the psychological research methods of Colazzi for data analysis informed this study. Four themes emerged from the data: Service users' the significance of methadone for the service user; service users' understanding of the Methadone Treatment Protocol and the experience of addiction and its effect on families.

This paper reports on the experiences of service users receiving methadone treatment in urban general practice in Dublin and in so doing highlights the influence of the GP in supporting recovery. It explores the theme - Service User's Experience of attending general practice for methadone treatment. These accounts provide insight into the harm reduction policy of methadone maintenance and highlight how - from the service users' experience - the implementation is falling short.

Keywords

Methadone treatmentgeneral practiceservice users.
Type
Original Paper
Information
Irish Journal of Psychological Medicine , Volume 29 , Issue 3 , 2012 , pp. 147 - 156
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Matheson, C, Pitcairn, J, Bond, CM, van Teijlingen, E, Ryan, M. General practice management of illicit drug users in Scotland: a national survey. Addiction, 2003, 98:119–26.CrossRefGoogle ScholarPubMed
2.Strang, J, Sheridan, J, Hunt, C, Kerr, B, Gerada, C, Pringle, M. The prescribing of methadone and other opioids to addicts: national survey of GPs in England and Wales. BJGP, 2005;55:444–51.Google ScholarPubMed
3.Buckley, J. Drug Addiction Treatment and Rehabilitation Comptroller and Auditor General Special Report, 2009; Department of Community, Rural and Gaeltacht Affairs. Gov of I.Google Scholar
4.Delargy, I. Survey of General Practitioners Participating in the Methadone Treatment Programme. 2008; ICGP. Lincoln Place, Dublin 2.Google Scholar
5.Irish College of General Practitioners. Working with Opiate Users in Community Based Primary Care.2008; Published by the ICGP, Lincoln Place, Dublin 2.Google Scholar
6.Fischer, B, Chin, A.T., Kuo, I, Kirst, M, Vlahov, D. Canadian Illicit Opiate Users' Views on Methadone and Other Opiate Prescription Treatment. Subst Use & Misuse, 2002; 37 (4), 495–522CrossRefGoogle ScholarPubMed
7.Fischer, J, Jenkins, N, Bloor, M, Neale, J, Berney, L. Drug User involvement in treatment decisions. 2007; Joseph Rowntree Foundation, The Homestead, 40 Water End, York YO306WP 1–45.Google Scholar
8.Fischer, J, Neale, J, Bloor, M, Jenkins, N. Conflict and user involvement in drug misuse treatment decision-making: a qualitative study. Subst Abuse Treatment, Prevention, & Policy, 2008; 3:21 PMID: 18837989CrossRefGoogle ScholarPubMed
9.MarchCerda, JC, Martin Ruiz, E, Oviedo Joekes, E, Rivadeneira, E, Rodriquez, S, Reinado, C. Methadone Treatment Programme Users' perceptions of the accessibility and care received from the therapeutic teams. Addiction, 2006;18(4), 359–369Google Scholar
10.Gourlay, J, Ricciardelli, L, Ridge, D. Users' Experience of heroin and methadone treatment. Subst Use & Misuse, 2005;40(12), 1875–1882CrossRefGoogle ScholarPubMed
11.Madden, A, Lea, T, Bath, N, Winstock, A. Satisfaction guaranteed? What clients on methadone and buprenorphine think about their treatment. Drug Alcohol Rev, 2008;27, 671–678CrossRefGoogle ScholarPubMed
12.McKeganey, N, Morris, Z, Neale, J, Robertson, R. What are drug misusers looking for when they contact drug services: abstinence or harm reduction? Drugs: Ed, Prevent & Policy, 2004; 11(5), 423–435.Google Scholar
13.Nilsen, E.S., Mythaug, H.T, Johansen, M., Oxman, A.D. (2006). Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. Cochrane Database System Review 2006 (3) CD004563.CrossRefGoogle ScholarPubMed
14.Fischer, J, Jenkins, N, Bloor, M, Neale, J, Berney, L. Drug User involvement in treatment decisions. 2007; Joseph Rowntree Foundation, The Homestead, 40, Water End, York YO306WP 1–45.Google Scholar
15.Fischer, J, Neale, J, Bloor, M, Jenkins, N. Conflict and user involvement in drug misuse treatment decision making: a qualitative study. Subst,Treatment Prevention & Policy, 2008;3:21 PMID:18837989CrossRefGoogle ScholarPubMed
16.McEvoy, R. Service user involvement in the Irish health service: a review of the evidence. HSE& DOH, 2008; http://hdl.handle.net/10147/45885Google Scholar
17.O'Connor, S. Pharmaceutical Services for patients in Methadone treatment in Ireland. The introduction of the Methadone Protocol Scheme. Ph.D. Thesis, 2002; Trinity College Dublin.Google Scholar
18.Union for Improved Services, Communication, and Education. UISCE Methadone: What's the Story? 2003; 1–34.Google Scholar
19.Lawless, M, Cox, G. Maintaining or Enabling? An evaluation of a methadone prescribing service In Dublin City in: Pieces of the Jigsaw –Six reports addressing homelessness and drug use in Ireland. 2003; Merchants Quay Ireland. Homeless & Drugs Services, 4 Merchants Quay, D8Google Scholar
20.O'Reilly, F, Reaper, E, Redmond, T. We're people too: Views of drug users on health services. 2005; Participation & Practice of Rights project, UISCE & Mountjoy Street Family Practice, Dublin,Google Scholar
21.Wilkinson, S., Mistral, W, GP Experiences and Perceptions of Methadone Maintenance in the Eastern Region of Ireland. 2003; Mental Health RDU, Uof Bath, on behalf of the ERHB.Google Scholar
22. Ballymun Youth Action Project. Benzodiazepines-whose little helper? The role of benzodiazepines in the development of substance misuse problems in Ballymun Dublin: 2004; NACD.Google Scholar
23. Irish College of General Practitioners Research Strategy. 2003–2008; ICGP, Lincoln Place, D 2.Google Scholar
24.Olier, C. The Phenomenological Approach in Nursing Research. Nurs Res, 1981; 31 (3), 178–181.Google Scholar
25.Crabtree, BF, Miller, Wl. Doing Qualitative Research. Sage Publications, 1999; 2nd edn.Google Scholar
26.Patton, M. Qualitative Evaluation and Research methods. Beverly Hills, CA: Sage 1990; 169–186Google Scholar
27.Wilmot, A. Designing sampling strategies for qualitative social research: with particular reference to the Office for National Statistics' Qualitative Respondent Register. QUEST 2005.Google Scholar
28.Polkinghorne, DEPhenomenological Research Methods In: Existential– phenomenological perspectives in psychology (Valle, R.S, Halling, S. eds) Plenum Press, New York, 1989;CH3:41–60.CrossRefGoogle Scholar
29.Latham, L. An explorative study of the perceptions and Experiences of practice nurses in relation to patients on a methadone treatment protocol. Unpublished MSc Thesis, 2003;UCD.Google Scholar
30.Colaizzi, PF. Psychological Research as the Phenomenologist Views It: In: Existential– phenomenological alternatives for psychology. (Valle, R. S.King, M.eds) Oxford University Press, 1978; Ch: 3:48–71Google Scholar
31.Rhodes, T, Kimber, J, Small, W, Fitzgerald, J, Kerr, T, Hickman, M, Holloway, G. Public injecting and the need for ‘safer environment interventions’ in the reduction of drug-related harm. Addiction, 2006; 101(10), 1384–1393CrossRefGoogle ScholarPubMed
32.Kerr, T, Kimber, J, Rhodes, T. Drug user settings: An emerging focus for research and intervention. Int J Drug Policy, 2007; 18(1), 1–4CrossRefGoogle Scholar
33.Gillies Mercer, S, Lyon, A, Scott, M, Watt, G. (2009) Distilling the essence of general practice: a learning journey in practice. BJGP, 2009; 59 (562)356–363Google Scholar
34.Ambreen, A, Keenan, E, Casey, P. Consumer satisfaction with methadone maintenance programmes survey. Irish Psychiatrist, 2008; 9(2) 91–93Google Scholar
35.Freeman, G, Hjortdahl, P. What future for continuity of care in general practice? BMJ, 1997; 314:1870CrossRefGoogle ScholarPubMed
36.Stokes, T, Dixon-Woods, M, McKinley, R. Ending the doctor–patient relationship in general practice: a proposed model. Fam Pract, 2004; 21(5), 507–514; doi:10.1093/fampra/cmh506CrossRefGoogle ScholarPubMed
37.McCormick, J. Death of the personal doctor. Lancet, 1996; 348:667–8CrossRefGoogle ScholarPubMed
38.Pendleton, D. The Consultation: An approach to learning and teaching. 1984. Oxford University PressGoogle Scholar
39.Neighbour, R. The Inner Consultation: How to develop an effective & intuitive consulting style. 1984.Google Scholar
40.Kurtz, SM, Silverman, JD, Draper, J. Teaching & learning communication skills in medicine. R, 1998; Radcliffe Medical Press, Oxford.Google Scholar
41.Fischer, J, Jenkins, N, Bloor, M, Neale, J, Berney, L. Drug misuser involvement in treatment decisions. 2007; Joseph Rowntree Foundation, The Homestead, 40, Water End, York YO306WP 1–45.Google Scholar
42.Clarke, B. Drug using parents - the child care issues. Ir Soc Worker, 1994; 12 (2) 9.Google Scholar
43.Anderson, P, Kaner, E, Wutze, S, Wensing, M, Grol, R. Heather, N. Saunders, J. ‘Attitudes and management of alcohol problems in general practice: Descriptive analysis based on findings of a WHO, international collaborative survey’, Alcohol Alcohol, 2003; 38 (6) 597–601.CrossRefGoogle ScholarPubMed
44.O'Riordan, M, Skelton, J. laCroix, A. Heartlift patients? An interview –based study of GP trainers and the impact of ‘patients they like’. Fam Pract, 2003; 1–6Google Scholar
45.Lintzeris, N, Pritchard, E, Sciacchitano, L. Investigation of methadone dosing in Victoria: Factors influencing dosing levels. Fitzroy, Victoria: 2007; Turning Point Alcohol & Drug Centre.Google Scholar
46.Ford, C., Barnard, J, Bury, J, Carnwath, T, Gerada, C, Joyce, A. et al.Guidance for the use of methadone for the treatment of opioid dependence in primary care. RCGP Substance Misuse Unit RCGP. 2005; Sex, Drugs and HIV Task Group SMMGP. The Alliance. Available at www.smmGP.org.ukGoogle Scholar
47.Martin, E, Hawkins, S, Hicks, T, O'Flynn, M. Psychological services for adults in primary Care Ir Psychol, 2009; 35 (10), 281–288.Google Scholar
48.Madden, A, Lea, T, Bath, N, Winstock, A. Satisfaction guaranteed? What clients on methadone and buprenorphine think about their treatment. Drug Alcoh Rev, 2008; 27, 671–678.CrossRefGoogle ScholarPubMed