Grant: Travel Awards - Institute Community Support

For people with severe opioid use disorder (i.e. heroin addiction) not responding to first-line treatments, evidence supports the effectiveness of injectable opioid agonist treatment (iOAT), where patients inject pharmaceutical-grade opioids daily under the supervision of nurses. Outcomes include significant reductions in opioid use, crime, health improvements, and modest declines in illicit stimulant use (i.e. cocaine and amphetamines). This study was the first to investigate the experiences of iOAT patients that use illicit stimulants. The study aimed to investigate from the perspective of patients, the processes by which their use of illicit stimulants changed in context of daily iOAT care. Qualitative interviews were done with 31 patients at the first iOAT clinic in North America. Using a grounded theory approach sampling, data collection, and data analysis were conducted in a back and forth process. Interviews were audio-recorded and transcribed verbatim. The process of changing stimulant use in iOAT care was found to have four stages: 1) building capacity: where daily iOAT medication offered a sense of "freedom", and contact with care providers offered "connection"; 2) realizing potential: where participants described "identifying evolving goals" (e.g. relationships, health, employment) and "finding hope", seeing these goals as realistic; 3) taking action: where participants described "gaining control" over their stimulant use (e.g. practicing financial responsibility) and engaging in meaningful alternative activities (e.g. hobbies); 4) sustaining change: where participants described "recognizing progress" and "becoming experts" in their own health and service needs. When integrated, these four stages form the process of "pursuing change". Findings can support clinicians in understanding patients' evolving needs relating to their pursuit of stimulant use recovery in the context of iOAT care as treatment with injectable opioids expands across Canada.