When you are sitting there and people walk in, and they just, oh what are you doing there?... I feel a little bit degraded”: Consumer Experiences of Opioid Replacement Therapy in regional Victoria

Introduction and Aims: Orticare Network in Western Victoria identified the need to hear consumer perceptions about how existing opioid-replacement therapy (ORT) services are delivered. The study had two aims:
1. Evaluate ORT from the perspective of consumers in rural communities; and
2. Develop best practice guidelines that pays attention to consumers’ voices.
Design and Methods: The researchers undertook a phenomenological study through semi-structured interviews with participants in five different regional centres in Victoria. An expert advisory group of consumers and service providers gave guidance on the interview questions and helped shape the guidelines.
Results: The findings suggest that ORT treatment imposed psycho-social constraints on consumers because of the number of visits to the pharmacy, the cost of takeaways and the lack of coordination between the ORT prescriber, the General Practitioner (GP) and the pharmacist. It also impacted on their ability to work, meet family and social commitments and risk of depression, anxiety and misuse/diversion. Furthermore, participants made references to the stigma associated with pharmacy dosing because of lack of privacy and the sense that they were being judged.
Discussions and Conclusions: Participants spoke within the framework of marginality because their daily lives centred around managing the psycho-social impacts of the treatment regime. We contend that experiences of ORT consumers need to be analysed using psycho-social and marginality standpoints since it focuses on illuminating consumer voices rather than analysing the pharmacological benefits and/or effectiveness of ORT.
Implications for Practice or Policy:
1. Utilise team care plans where the ORT providers and other health services work together rather than consumers experiencing fractured medical assistance.
2. Pharmacies investigate ways to make dispensing sites welcoming and nondiscriminatory for ORT consumers.
Disclosure of Interest Statement: Orticare receives funding from the Victorian Department of Health and Human Services. Federation University is funded by the Commonwealth Government of Australia. No pharmaceutical grants were received in the development of this study.