Grant: Travel Awards - Institute Community Support

Many First Nations communities in Canada experience high rates of disease and death resulting from opioid use. The frequency of opioid-related emergency room visits and the higher occurrence of illicit prescription drug use disorders in First Nations populations suggest challenges. Methadone maintenance therapy programs are consistently found to be the most effective treatment for opioid dependence; however, due to financial, geographic, and cultural factors, First Nations individuals are less likely to begin methadone maintenance therapy. The present study aimed to evaluate the first on-reserve methadone maintenance therapy program in Canada by asking clients to share their "likes" and "dislikes" of the program. When sharing their "likes," seven common themes emerged: being off of drugs, program praise, new beginnings and pride, social relationships, money, psychological health, and physical health. These themes show that in the eyes of the clients, the program is making a positive difference and is well received. Clients also identified important indicators of improvement that fit with the literature's expectations for improvement and clients noticed improvements in everyday functioning. Recognizing these changes from the perspectives of the clients is essential to appreciating program success. When sharing their "dislikes," four common themes emerged: being on/getting methadone, social concerns, other treatment programming interests, and recommendations. The concerns that were raised matched concerns presented in the literature and clients' recommendations provide an excellent place to look for guidance for improving the program. Overall, the information gathered suggests that the program is effectively improving access to services and reducing substance use and related harms among clients.