Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study.

Marina Braden, Iain W. McGowan, Derek F. McLaughlin, Hugh P. McKenna, Sinead Keeney, Breige Quinn

Research output: Non-textual formWeb publication/site

3 Citations (Scopus)

Abstract

Aim: This paper reports on the treatment and care experiences for heroin dependency in a Northern Ireland Healthcare Trust.Background: There is a dearth of multi-dimensional heroin dependency treatment perspectives inbackground qualitative peer-reviewed literature. This is surprising given the influence of “consumer evaluation” in service development.Method: Focus groups were undertaken with separate purposive samples of ex/current heroin users(n = 7), carers of ex/current heroin users (n = 4) and professionals involved in heroin dependency service provision (n = 4). Non-directive question schedules elicited collective phenomenological experiences. Focus groups were transcribed verbatim and content analyzed.Findings: Study participants shared mainly dehumanizing experiences of treatment and care provision often characterized by non-communicative and judgemental health professional conduct. Unpredictable prescribing protocol and limited treatment resources have overshadowed any beneficial experiences of substitute prescribing in our pilot study. Findings also showed that participants requested treatment choice and holistic care provision.Conclusions: Incoherent drug treatment policy and communication breakdown between treatmentstakeholders has influenced a cyclical blame culture in this study.
LanguageEnglish
DOIs
Publication statusPublished - 27 Sep 2010

Fingerprint

Heroin
Caregivers
Focus Groups
Therapeutics
Northern Ireland
Clinical Protocols
Appointments and Schedules
Communication
Dependency (Psychology)
Delivery of Health Care
Health
Pharmaceutical Preparations

Keywords

  • Treatment experience
  • heroin dependency
  • focus groups

Cite this

Braden, M. (Author), McGowan, I. W. (Author), McLaughlin, D. F. (Author), McKenna, H. P. (Author), Keeney, S. (Author), & Quinn, B. (Author). (2010). Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study.. Web publication/site https://doi.org/10.3109/14659891.2010.495818
Braden, Marina (Author) ; McGowan, Iain W. (Author) ; McLaughlin, Derek F. (Author) ; McKenna, Hugh P. (Author) ; Keeney, Sinead (Author) ; Quinn, Breige (Author). / Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study.. [Web publication/site].
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title = "Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study.",
abstract = "Aim: This paper reports on the treatment and care experiences for heroin dependency in a Northern Ireland Healthcare Trust.Background: There is a dearth of multi-dimensional heroin dependency treatment perspectives inbackground qualitative peer-reviewed literature. This is surprising given the influence of “consumer evaluation” in service development.Method: Focus groups were undertaken with separate purposive samples of ex/current heroin users(n = 7), carers of ex/current heroin users (n = 4) and professionals involved in heroin dependency service provision (n = 4). Non-directive question schedules elicited collective phenomenological experiences. Focus groups were transcribed verbatim and content analyzed.Findings: Study participants shared mainly dehumanizing experiences of treatment and care provision often characterized by non-communicative and judgemental health professional conduct. Unpredictable prescribing protocol and limited treatment resources have overshadowed any beneficial experiences of substitute prescribing in our pilot study. Findings also showed that participants requested treatment choice and holistic care provision.Conclusions: Incoherent drug treatment policy and communication breakdown between treatmentstakeholders has influenced a cyclical blame culture in this study.",
keywords = "Treatment experience, heroin dependency, focus groups",
author = "Marina Braden and McGowan, {Iain W.} and McLaughlin, {Derek F.} and McKenna, {Hugh P.} and Sinead Keeney and Breige Quinn",
note = "Reference text: Bancroft, A., Carty, A., Cunningham-Burley, S., & Backett-Milburn, K. (2002). Support for the Families of Drug Users: A review of the literature. Edingburgh: Scottish Executive Effective Interventions Unit. Barbour, R. S., & Kitzinger, J. (Eds). (1999). Developing Focus Group Research: Politics, theory and practice. London: Sage. Barnard, M. (2005). Drugs in the Family: The impact on parents and siblings. York: Joseph Rowntree Foundation. Best, D., Campbell, A., & O’Grady, A. (2006). The NTA’s first annual user satisfaction survey 2005. London: NHS/ National Treatment Agency for Substance Misuse. Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11, 461–466. Copello, A. & Orford, J. (2002). Addiction and the family: Is it time for services to take notice of the evidence? Addiction, 97, 1361–1363. Cunningham-Burley, S., Kerr, A., & Pavis, S. (1999). Theorizing subjects and subject matter in focus group research. In: Barbour, R.S., & Kitzinger, J. (Eds), Developing Focus Group Research: Politics, theory and practice. Sage, London. J Subst Use Downloaded from informahealthcare.com by University of Ulster at Coleraine on 08/11/11 For personal use only. Experiences of heroin dependency care 11 Department of Health, Social Services and Public Safety (DHSSPS). (2006). New Strategic Direction for Alcohol and Drugs 2006–2011. Belfast: DHSSPS. Dobkin, P., De Civita, M., Paraherakis, A., & Gill, K. (2002). The role of functional support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97, 347–356. Drug and Alcohol Information and Research Unit (DAIRU)/Department of Health & Social Services and Public Safety Research (DHSS). (2006). Estimating the prevalence of Problem Opiate and Problem Cocaine Use in Northern Ireland. The Centre for Drug Misuse Research, University of Glasgow, on behalf of the Northern Ireland Drug and Alcohol Campaign. Fischer, B., Chin, A. T., Kuo, I., Kirst, M., & Vlahov, D. (2002). Canadian illicit opiate users’ views on methadone and other opiate prescription treatment: An exploratory qualitative study. Substance Use & Misuse, 37, 495–522. Freeman, T. (2006). Best practice in focus group research: Making sense of different views. Journal of Advanced Nursing, 56, 491–497. Gourlay, J., Ricciardelli, L., & Ridge, D. (2005). Users experiences of heroin and methadone treatment. Substance Use & Misuse, 40, 1875–1878. Happell, B., Carta, B., & Pinikahana, J. (2002). Nurses’ knowledge, attitudes and beliefs regarding substance use: A questionnaire survey. Nursing and Health Sciences, 4, 193–200. Higgins, K. & Kilpatrick, R. (2005). The impact of paramilitary violence against a heroin user community in Northern Ireland: A qualitative analysis. International Journal of Drug Policy, 16, 334–342. Kleber, H. (1993). The US anti-drug prevention strategy: Science and policy connections. In: Edwards, G., Strang, J., & Jaffe, J. (Eds) Drug, Alcohol and Tobacco: Making the science and policy connections. Oxford: Oxford University Press. Knodel, J. (1993). The Design and Analysis of Focus Group Studies: A practical approach. In: Morgan, D. L. (Ed.) Successful Focus Groups—Advancing the State of the Art. London: Sage Focus. Krueger, R. A. (1998). Analysing and Reporting Focus Group Results. Thousand Oaks, CA: Sage Publications. Marinelli-Casey, P., Domier, C. P., & Rawson, R. A. (2002). The gap between research and practice in substance abuse treatment. Psychiatric Services, 53, 984–987. Marsh, J., D’Aummo, T., & Smith, B. (2000). Increasing access and providing social services to improve drug use treatment for women with children. Addiction, 95, 1237–1247. McElrath, K. (2001). Heroin Use in Northern Ireland: A qualitative study into heroin users’ lifestyles, experiences and risk behaviours (1997–1999). London: HMSO. McElrath, K. & Jordan, M. (2005). Drug Use and Risk Behaviours among Injecting Drug Users, review commissioned by the Drug and Alcohol Information and Research Unit, Department of Health, Social Services and Public Safety on behalf of Northern Ireland Drugs and Alcohol Campaign. McKeganey, N., Morris, Z., Neale, J., & Robertson, M. (2004). What are drug users looking for when they contact drug services: Abstinence or harm reduction? Drugs: Education, Prevention and Policy, 11, 423–435. McLafferty, I. (2004). Focus group interviews as a data collecting strategy. Journal of Advanced Nursing, 48, 187–194. McLaughlin, D. F., McKenna, H. P, & Leslie, J. C. (2000). The perceptions and aspirations illicit drug users hold toward health care staff and the care they receive. Journal of Psychiatric and Mental Health Nursing, 7, 435–441. McLaughlin, D. F., McKenna, H. P., Leslie, J. C., Robinson, J., & Moore, K. (2006). Illicit drug users in Northern Ireland: Perceptions and experiences of health and social care professionals. Journal of Psychiatric and Mental Health Nursing, 13, 682–686. Merrill, J. & Ruben, S. (2005). Treating drug dependence in primary care. In: Strang, J., & Gossop, M. (Eds) Heroin Addiction and the British System: Treatment and policy responses, (Vol. 2). London: Routledge. Mistral, W., & Velleman, R. (2001). Substance-misusing patients in primary care: Incidence, services provided and problems. A survey of general practitioners in Wiltshire. Drugs: Education, Prevention and Policy, 8, 61–72. Morgan, D. L. (1998). Planning Focus Groups: Focus Group Kit 2. London: Sage Publications. Morgan, D. L. & Krueger, R. A. (1993). When to use focus groups and why. In: Morgan, D. L. (Ed.) Successful Focus Groups—Advancing the State of the Art. London: Sage Focus. National Treatment Agency for Substance Misuse. (2006). Models of Care for Treatment of Adult Drug Misusers: Update 2006. London: Department of Health/Home Office. Neale, J. (1998). Drug users’ views of drug service providers. Health and Social Care in the Community, 6, 308–317. Neale, J., Shread, L., & Tompkins, C. N. E. (2007). Factors that help injecting drug users to access and benefit from services: A qualitative study. Substance Abuse Treatment, Prevention & Policy, 2, 31. Neuendorf, K. A. (2002). The Content Analysis Guidebook. London: Sage Publications. Newell, R. & Burnard, P. (2006). Research for Evidence-based Practice. Oxford: Blackwell Publishing Ltd. Northern Ireland Office. (1999). Drug Strategy for Northern Ireland. Belfast: NIO. J Subst Use Downloaded from informahealthcare.com by University of Ulster at Coleraine on 08/11/11 For personal use only. 12 M. Braden et al. Northern Ireland Statistics and Research Agency (NISRA). (2006). Statistics from the Northern Ireland Substitute Prescribing Database: 31st March 2006. Belfast: Department of Health, Social Services and Public Safety, NISRA. Parahoo, K. (2006). Nursing Research: Principles, process and issues. Basingstoke: Palgrave MacMillan. Peckover, S. & Childlaw, R. G. (2007). Too frightened to care? Accounts by district nurses working with clients who misuse substances. Health & Social Care in the Community, 15, 238–245. Police Service of Northern Ireland. (2007). Drug Seizures & Arrests. Statistical Report No. 4. (1st April 2006-31st March 2007). Belfast: Central Statistics Branch, PSNI. Polit, D. F. & Beck, C. T. (2004). Nursing Research: Principles and Methods. Philadelphia: Lippincott Williams and Wilkins. Rassool, G. H. (2000). Addiction: Global problem and global response. Complacency or commitment. Journal of Advanced Nursing, 32, 505–507. Renzetti, C. M. & Lee, R. L. (Eds). (1993). Researching Sensitive Topics. London: Sage Publications. Royal Ulster Constabulary. (1996). Chief Constable’s Annual Report 1995. London: HMSO. Sell, L. & Zador, D. (2004). Patients prescribed injectable heroin or methadone—their opinions and experiences of treatment. Addiction, 99, 442–449. Sim, J. (1998). Collecting and analysing qualitative data: Issues raised by the focus group. Journal of Advanced Nursing, 28, 345–352. Sims, H. (2002). Families in Focus England: A report on a series of consultative conversations held in urban and rural areas of England during late 2001 and early 2002. London: ADFAM. Small, D. & Drucker, E. (2006). Policy makers ignoring science and scientists ignoring policy: The medical ethical challenges of heroin treatment. Harm Reduction Journal, 3, 16. Strang, J. & Gossop, M. (2005). The British System of drug policy: Extraordinary individual freedom, but to what end? In: Strang, J. & Gossop, M. (Eds) Heroin Addiction and the British System: Treatment and policy responses. (Vol. 2). London: Routledge. Treleor, C. & Holt, M. (2006). Deficit models and divergent philosophies: Service providers’ perspectives on barriers and incentives to drug treatment. Drugs: Education, Prevention and Policy, 13, 367–382.",
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Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study. Braden, Marina (Author); McGowan, Iain W. (Author); McLaughlin, Derek F. (Author); McKenna, Hugh P. (Author); Keeney, Sinead (Author); Quinn, Breige (Author). 2010.

Research output: Non-textual formWeb publication/site

TY - ADVS

T1 - Users, carers and professionals experiences of treatment and care for heroin dependency: Implications for practice. A preliminary study.

AU - Braden, Marina

AU - McGowan, Iain W.

AU - McLaughlin, Derek F.

AU - McKenna, Hugh P.

AU - Keeney, Sinead

AU - Quinn, Breige

N1 - Reference text: Bancroft, A., Carty, A., Cunningham-Burley, S., & Backett-Milburn, K. (2002). Support for the Families of Drug Users: A review of the literature. Edingburgh: Scottish Executive Effective Interventions Unit. Barbour, R. S., & Kitzinger, J. (Eds). (1999). Developing Focus Group Research: Politics, theory and practice. London: Sage. Barnard, M. (2005). Drugs in the Family: The impact on parents and siblings. York: Joseph Rowntree Foundation. Best, D., Campbell, A., & O’Grady, A. (2006). The NTA’s first annual user satisfaction survey 2005. London: NHS/ National Treatment Agency for Substance Misuse. Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11, 461–466. Copello, A. & Orford, J. (2002). Addiction and the family: Is it time for services to take notice of the evidence? Addiction, 97, 1361–1363. Cunningham-Burley, S., Kerr, A., & Pavis, S. (1999). Theorizing subjects and subject matter in focus group research. In: Barbour, R.S., & Kitzinger, J. (Eds), Developing Focus Group Research: Politics, theory and practice. Sage, London. J Subst Use Downloaded from informahealthcare.com by University of Ulster at Coleraine on 08/11/11 For personal use only. Experiences of heroin dependency care 11 Department of Health, Social Services and Public Safety (DHSSPS). (2006). New Strategic Direction for Alcohol and Drugs 2006–2011. Belfast: DHSSPS. Dobkin, P., De Civita, M., Paraherakis, A., & Gill, K. (2002). The role of functional support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97, 347–356. Drug and Alcohol Information and Research Unit (DAIRU)/Department of Health & Social Services and Public Safety Research (DHSS). (2006). Estimating the prevalence of Problem Opiate and Problem Cocaine Use in Northern Ireland. The Centre for Drug Misuse Research, University of Glasgow, on behalf of the Northern Ireland Drug and Alcohol Campaign. Fischer, B., Chin, A. T., Kuo, I., Kirst, M., & Vlahov, D. (2002). Canadian illicit opiate users’ views on methadone and other opiate prescription treatment: An exploratory qualitative study. Substance Use & Misuse, 37, 495–522. Freeman, T. (2006). Best practice in focus group research: Making sense of different views. Journal of Advanced Nursing, 56, 491–497. Gourlay, J., Ricciardelli, L., & Ridge, D. (2005). Users experiences of heroin and methadone treatment. Substance Use & Misuse, 40, 1875–1878. Happell, B., Carta, B., & Pinikahana, J. (2002). Nurses’ knowledge, attitudes and beliefs regarding substance use: A questionnaire survey. Nursing and Health Sciences, 4, 193–200. Higgins, K. & Kilpatrick, R. (2005). The impact of paramilitary violence against a heroin user community in Northern Ireland: A qualitative analysis. International Journal of Drug Policy, 16, 334–342. Kleber, H. (1993). The US anti-drug prevention strategy: Science and policy connections. In: Edwards, G., Strang, J., & Jaffe, J. (Eds) Drug, Alcohol and Tobacco: Making the science and policy connections. Oxford: Oxford University Press. Knodel, J. (1993). The Design and Analysis of Focus Group Studies: A practical approach. In: Morgan, D. L. (Ed.) Successful Focus Groups—Advancing the State of the Art. London: Sage Focus. Krueger, R. A. (1998). Analysing and Reporting Focus Group Results. Thousand Oaks, CA: Sage Publications. Marinelli-Casey, P., Domier, C. P., & Rawson, R. A. (2002). The gap between research and practice in substance abuse treatment. Psychiatric Services, 53, 984–987. Marsh, J., D’Aummo, T., & Smith, B. (2000). Increasing access and providing social services to improve drug use treatment for women with children. Addiction, 95, 1237–1247. McElrath, K. (2001). Heroin Use in Northern Ireland: A qualitative study into heroin users’ lifestyles, experiences and risk behaviours (1997–1999). London: HMSO. McElrath, K. & Jordan, M. (2005). Drug Use and Risk Behaviours among Injecting Drug Users, review commissioned by the Drug and Alcohol Information and Research Unit, Department of Health, Social Services and Public Safety on behalf of Northern Ireland Drugs and Alcohol Campaign. McKeganey, N., Morris, Z., Neale, J., & Robertson, M. (2004). What are drug users looking for when they contact drug services: Abstinence or harm reduction? Drugs: Education, Prevention and Policy, 11, 423–435. McLafferty, I. (2004). Focus group interviews as a data collecting strategy. Journal of Advanced Nursing, 48, 187–194. McLaughlin, D. F., McKenna, H. P, & Leslie, J. C. (2000). The perceptions and aspirations illicit drug users hold toward health care staff and the care they receive. Journal of Psychiatric and Mental Health Nursing, 7, 435–441. McLaughlin, D. F., McKenna, H. P., Leslie, J. C., Robinson, J., & Moore, K. (2006). Illicit drug users in Northern Ireland: Perceptions and experiences of health and social care professionals. Journal of Psychiatric and Mental Health Nursing, 13, 682–686. Merrill, J. & Ruben, S. (2005). Treating drug dependence in primary care. In: Strang, J., & Gossop, M. (Eds) Heroin Addiction and the British System: Treatment and policy responses, (Vol. 2). London: Routledge. Mistral, W., & Velleman, R. (2001). Substance-misusing patients in primary care: Incidence, services provided and problems. A survey of general practitioners in Wiltshire. Drugs: Education, Prevention and Policy, 8, 61–72. Morgan, D. L. (1998). Planning Focus Groups: Focus Group Kit 2. London: Sage Publications. Morgan, D. L. & Krueger, R. A. (1993). When to use focus groups and why. In: Morgan, D. L. (Ed.) Successful Focus Groups—Advancing the State of the Art. London: Sage Focus. National Treatment Agency for Substance Misuse. (2006). Models of Care for Treatment of Adult Drug Misusers: Update 2006. London: Department of Health/Home Office. Neale, J. (1998). Drug users’ views of drug service providers. Health and Social Care in the Community, 6, 308–317. Neale, J., Shread, L., & Tompkins, C. N. E. (2007). Factors that help injecting drug users to access and benefit from services: A qualitative study. Substance Abuse Treatment, Prevention & Policy, 2, 31. Neuendorf, K. A. (2002). The Content Analysis Guidebook. London: Sage Publications. Newell, R. & Burnard, P. (2006). Research for Evidence-based Practice. Oxford: Blackwell Publishing Ltd. Northern Ireland Office. (1999). Drug Strategy for Northern Ireland. Belfast: NIO. J Subst Use Downloaded from informahealthcare.com by University of Ulster at Coleraine on 08/11/11 For personal use only. 12 M. Braden et al. Northern Ireland Statistics and Research Agency (NISRA). (2006). Statistics from the Northern Ireland Substitute Prescribing Database: 31st March 2006. Belfast: Department of Health, Social Services and Public Safety, NISRA. Parahoo, K. (2006). Nursing Research: Principles, process and issues. Basingstoke: Palgrave MacMillan. Peckover, S. & Childlaw, R. G. (2007). Too frightened to care? Accounts by district nurses working with clients who misuse substances. Health & Social Care in the Community, 15, 238–245. Police Service of Northern Ireland. (2007). Drug Seizures & Arrests. Statistical Report No. 4. (1st April 2006-31st March 2007). Belfast: Central Statistics Branch, PSNI. Polit, D. F. & Beck, C. T. (2004). Nursing Research: Principles and Methods. Philadelphia: Lippincott Williams and Wilkins. Rassool, G. H. (2000). Addiction: Global problem and global response. Complacency or commitment. Journal of Advanced Nursing, 32, 505–507. Renzetti, C. M. & Lee, R. L. (Eds). (1993). Researching Sensitive Topics. London: Sage Publications. Royal Ulster Constabulary. (1996). Chief Constable’s Annual Report 1995. London: HMSO. Sell, L. & Zador, D. (2004). Patients prescribed injectable heroin or methadone—their opinions and experiences of treatment. Addiction, 99, 442–449. Sim, J. (1998). Collecting and analysing qualitative data: Issues raised by the focus group. Journal of Advanced Nursing, 28, 345–352. Sims, H. (2002). Families in Focus England: A report on a series of consultative conversations held in urban and rural areas of England during late 2001 and early 2002. London: ADFAM. Small, D. & Drucker, E. (2006). Policy makers ignoring science and scientists ignoring policy: The medical ethical challenges of heroin treatment. Harm Reduction Journal, 3, 16. Strang, J. & Gossop, M. (2005). The British System of drug policy: Extraordinary individual freedom, but to what end? In: Strang, J. & Gossop, M. (Eds) Heroin Addiction and the British System: Treatment and policy responses. (Vol. 2). London: Routledge. Treleor, C. & Holt, M. (2006). Deficit models and divergent philosophies: Service providers’ perspectives on barriers and incentives to drug treatment. Drugs: Education, Prevention and Policy, 13, 367–382.

PY - 2010/9/27

Y1 - 2010/9/27

N2 - Aim: This paper reports on the treatment and care experiences for heroin dependency in a Northern Ireland Healthcare Trust.Background: There is a dearth of multi-dimensional heroin dependency treatment perspectives inbackground qualitative peer-reviewed literature. This is surprising given the influence of “consumer evaluation” in service development.Method: Focus groups were undertaken with separate purposive samples of ex/current heroin users(n = 7), carers of ex/current heroin users (n = 4) and professionals involved in heroin dependency service provision (n = 4). Non-directive question schedules elicited collective phenomenological experiences. Focus groups were transcribed verbatim and content analyzed.Findings: Study participants shared mainly dehumanizing experiences of treatment and care provision often characterized by non-communicative and judgemental health professional conduct. Unpredictable prescribing protocol and limited treatment resources have overshadowed any beneficial experiences of substitute prescribing in our pilot study. Findings also showed that participants requested treatment choice and holistic care provision.Conclusions: Incoherent drug treatment policy and communication breakdown between treatmentstakeholders has influenced a cyclical blame culture in this study.

AB - Aim: This paper reports on the treatment and care experiences for heroin dependency in a Northern Ireland Healthcare Trust.Background: There is a dearth of multi-dimensional heroin dependency treatment perspectives inbackground qualitative peer-reviewed literature. This is surprising given the influence of “consumer evaluation” in service development.Method: Focus groups were undertaken with separate purposive samples of ex/current heroin users(n = 7), carers of ex/current heroin users (n = 4) and professionals involved in heroin dependency service provision (n = 4). Non-directive question schedules elicited collective phenomenological experiences. Focus groups were transcribed verbatim and content analyzed.Findings: Study participants shared mainly dehumanizing experiences of treatment and care provision often characterized by non-communicative and judgemental health professional conduct. Unpredictable prescribing protocol and limited treatment resources have overshadowed any beneficial experiences of substitute prescribing in our pilot study. Findings also showed that participants requested treatment choice and holistic care provision.Conclusions: Incoherent drug treatment policy and communication breakdown between treatmentstakeholders has influenced a cyclical blame culture in this study.

KW - Treatment experience

KW - heroin dependency

KW - focus groups

U2 - 10.3109/14659891.2010.495818

DO - 10.3109/14659891.2010.495818

M3 - Web publication/site

ER -