School of Social Work and Social Policy, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland.
School of Social Work and Social Policy, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland.
Int J Drug Policy. 2021 Apr;90:103092. doi: 10.1016/j.drugpo.2020.103092. Epub 2021 Jan 8.
This paper examines the experiences of long-term clients of methadone maintenance treatment (MMT) in one area of Dublin in the context of a recent emphasis on rehabilitation and recovery in Irish drug policy.
In-depth qualitative interviews were conducted with 25 long-term clients of methadone maintenance treatment (MMT). All participants had first enrolled in methadone treatment at least ten years prior to participating in the research and a majority (n = 16) had first accessed MMT more than 20 years previously.
While acknowledging several beneficial aspects of methadone treatment, research participants saw themselves as passive recipients of a clinical regime that offered no opportunity to exercise agency in relation to their ongoing treatment. Rather than perceiving themselves as progressing along a pathway to recovery, the treatment experience was depicted in terms of stasis or confinement. Neither did participants report any progress in attaining the kind of social reintegration that is commonly presented as a key aspect of addiction recovery and which, in the Irish context, is a central plank of drug policy discourse.
The findings highlight a disconnect between policies that ostensibly aim to promote social reintegration and recovery and the experiences of individuals who are long-term clients of MMT. Irish policy aspirations of facilitating opiate-dependent clients to progress along a pathway to recovery are difficult, if not impossible, to realise given the marginal status of addiction services within the health system and the difficulties involved in securing ongoing cooperation from other public service sectors.
本文考察了都柏林一个地区接受美沙酮维持治疗（MMT）的长期患者的经历，这是在爱尔兰毒品政策中最近强调康复和恢复的背景下进行的。
对 25 名接受美沙酮维持治疗（MMT）的长期患者进行了深入的定性访谈。所有参与者首次参加美沙酮治疗至少在参与研究的十年前，大多数（n=16）首次接受 MMT 治疗的时间超过 20 年。
尽管参与者承认美沙酮治疗的几个有益方面，但他们认为自己是临床治疗制度的被动接受者，该制度没有提供任何机会行使他们与持续治疗相关的代理权。他们没有将自己视为沿着康复之路前进，而是将治疗经历描绘为停滞或禁锢。参与者也没有报告在实现通常被视为成瘾康复的关键方面的那种社会重新融入方面取得任何进展，而在爱尔兰背景下，这是毒品政策话语的核心内容之一。
这些发现突显了那些表面上旨在促进社会重新融入和康复的政策与长期接受 MMT 的个人的经历之间存在脱节。鉴于成瘾服务在卫生系统中的边缘地位以及从其他公共服务部门获得持续合作的困难，爱尔兰政策旨在促进阿片类药物依赖患者沿着康复之路前进的愿望很难实现，如果不是不可能的话。
