A chance to stop and breathe: participants’ experiences in the North American Opiate Medication Initiative clinical trial

Date

2014-09-29

Authors

Oviedo-Joekes, Eugenia
Marchand, Kirsten
Lock, Kurt
Chettiar, Jill
Marsh, David C.
Brissette, Suzanne
Anis, Aslam H
Schechter, Martin T

Journal Title

Journal ISSN

Volume Title

Publisher

Addiction Science & Clinical Practice

Abstract

Background: The North American Opiate Medication Initiative (NAOMI) clinical trial compared the effectiveness of injectable diacetylmorphine (DAM) or hydromorphone (HDM) to oral methadone maintenance treatment (MMT). This study aimed to determine participants’ perceptions of treatment delivered in NAOMI. Methods: A qualitative sub-study was conducted with 29 participants (12 female): 18 (62.1%) received injectable DAM or HDM and 11 (37.9%) received MMT. A phenomenological theoretical framework was used. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis was used over successive phases and was driven by the semantic meanings of the data. Results: Participants receiving injectable medications suggested that the supervised delivery model was stringent but provided valuable stability to their lives. Females discussed the adjustment required for the clinical setting, while males focused on the challenging clinic schedule and its impact on employment abilities. Participants receiving MMT described disappointment with being randomized to this treatment; however, positive aspects, including the quick titration time and availability of auxiliary services, were also discussed. Conclusion: Treatment with injectable DAM (or HDM) is preferred by participants and considered effective in reducing the burden of opioid dependency. Engaging patients in research regarding their perceptions of treatment provides a comprehensive assessment of treatment needs and barriers. Clinical trial registration: NCT00175357

Description

BioMed Central

Keywords

Opioid dependency, Diacetylmorphine, Injectable, Oral methadone, Opioid maintenance treatment, Qualitative methods

Citation

Oviedo-Joekes et al.: A chance to stop and breathe: participants’ experiences in the North American Opiate Medication Initiative clinical trial. Addiction Science & Clinical Practice 2014 9:21.