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‘Not just M ethadone T racy’: transformations in service‐user identity following the introduction of hepatitis C treatment into A ustralian opiate substitution settings
Author(s) -
Rance Jake,
Treloar Carla
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12392
Subject(s) - medicine , methadone , hepatitis c , ethos , opiate substitution treatment , harm reduction , psychiatry , intervention (counseling) , service (business) , family medicine , public health , psychology , nursing , buprenorphine , opioid , political science , receptor , economy , law , economics
Aims To explore identity transformation among service users attending opiate substitution therapy ( OST ) clinics following the introduction of hepatitis C ( HCV ) care and treatment. Design An interview‐based substudy of the A ustralian ETHOS (Enhancing Treatment for Hepatitis C in Opiate Substitution Settings) project. Setting Three OST clinics and one community health centre (operating a public OST ) in N ew S outh W ales, A ustralia. Participants were interviewed at the recruitment sites. Participants The sample consisted of 57 OST service users concurrently living with HCV , 16 staff, including specialist HCV clinicians, and three peer‐support workers, employed on the ETHOS project. Measurements Semi‐structured interviews. Findings Service‐user participants largely welcomed the introduction of HCV treatment as a practical, clinical intervention that also intimated a more comprehensive, holistic form of care. Negative stereotypes characteristic of OST settings—of limited, routinized clinical exchanges and minimal social‐care interaction—were unsettled, opening up the possibility of new relations between staff and service users. The shift in the dynamic of the clinical encounter to address health in addition to dependence appeared to catalyse transformative possibilities not only for the therapeutic alliance but also for service‐user understandings of self and identity. Conclusion Trial introduction of HCV care and treatment in selected A ustralian opiate substitution therapy (OST) clinics may have facilitated alternative, ‘non‐addict’ identities to emerge from a clinical setting where the stigmatizing figure of ‘the drug user’ has traditionally prevailed.