Background
Client involvement
Method
Gender | Total | Age (years) | Years in the OMT |
---|---|---|---|
Male | 2 | 26–35 | 1–3 |
1 | 46–55 | 15 | |
Female | 2 | 36–45 | 3–11 |
2 | 46–55 | 8–12 |
Ethical considerations
Results
Main category | ‘A better life – if you follow the rules of the game’ | |||
---|---|---|---|---|
Categories | To get your life back | The asymmetrical power balance | OMT as demotivator | A feeling of infringement |
Sub-categories | A feeling of freedom | Lack of co-determination in OMT | Unsatisfactory follow-up | Stigma |
To build trust | Fear of punishment | Suspicion never stops | Not being believed | |
Improved quality of life | Differences between OMT districts | The negative focus |
To get your life back
For me who wants to become totally drug free it is positive that with OMT you have a certain supervision. That there is a certain control and meetings with the responsibility group.
And then I got the necessary self-confidence and I dared to go out … and now I actually apply for proper jobs.
Before it was the first thing you thought about when you woke up in the morning and the last thing you thought about before you went to bed, and the whole day centred around that. But now you wake up in the morning, put a pill under your tongue and get going, and the day is just like any other day. You don’t think about it 24 h a day, like you did before.
The asymmetrical power balance
There they are sitting, the three people that somehow have power over me, sitting there and go through the things I’ve done and how they perceive me. I also feel that if there is something I want to say in the meeting, it is not always taken fully into account. As if they have decided in advance what will be said.
You have no influence over the treatment.
There is a reason why it is heroin that we use. It’s because it works best. It cures both anxiety and nerves and abstinence. It’s somehow the ultimate drug. I think that many of those who don’t succeed with OMT may have managed if they had received heroin instead.
In some places, suddenly everyone must use Suboxone. You feel that you are part of a group that some people feel they can do as they please with.
You are afraid of punishment. So my attitude has always been: ‘Say as little as possible, and certainly nothing that can be used against you later on.’
… they even threaten to take away my methadone, so I immediately began to step down the pills … . You can’t call that collaboration … I don’t have much choice. If they take my methadone away from me, it is very likely that I will end up in my grave.
The OMT programme as a demotivator
That’s a little special with OMT, they are very drug focused. It is not so important that you have bought an apartment or go to school or … . It’s like ‘Yeah, but have you been taking drugs?’ You can sit all alone at home and have anxiety and a terrible life, but clean urine samples. And then you are sort of clever!
In the responsibility groups, that everyone is a member of, there should be someone who has stopped abusing drugs and who has participated in OMT. This person may be called an employee with personal experience. Because those who have never been stoned don’t know what we’re talking about! They pretend that they do, but they don’t, you know!
You feel like a criminal. It is as if they assume that you will try to trick and cheat. As if they think that after all you are just a junkie, so they cannot entirely trust you!
A feeling of infringement
There is not much that makes me angrier than to hear their condescending attitude!
I wish they would see us as individuals rather than to think that all OMT clients are dirty drug addicts who will do anything to get something to get high on.
We’re still a bit like second-rate citizens. There are not many other patient groups who have to come on certain days and fetch their medication, and at any time may get a phone call and be ordered to submit a urine sample while someone watches them pee.