Presenting author: Kari Lancaster
Presenting author biography:
Kari Lancaster is Scientia Associate Professor at the Centre for Social Research in Health at the University of New South Wales, and Honorary Associate Professor at London School of Hygiene and Tropical Medicine. She uses qualitative methods to study evidence-making practices and intervention translations in relation to drugs and health.
The social, material and temporal effects of monthly extended-release buprenorphine depot treatment for opioid dependence: an Australian qualitative study
Kari Lancaster, Sandra Gendera, Carla Treloar, Tim Rhodes, Jeyran Shahbazi, Marianne Byrne, Louisa Degenhardt, Michael Farrell
Aims: This study examined the social, material and temporal effects of extended-release buprenorphine depot treatment (BUP-XR), among a group of participants commencing BUP-XR in Australia, and considered the situated potentials of these new opioid agonist treatment technologies.
Methods: Using a longitudinal qualitative design, 36 participants (25 men, 11 women; mean age 44 years) were interviewed, with 32 followed-up, to generate accounts of BUP-XR experiences. Analysis was informed by sociological approaches which attend to the multiple effects of novel health interventions as they are put to use and made to work, with a focus on tracing change over time.
Analysis: The shift from daily to monthly dosing altered how opioid agonist treatment was experienced, reconfigured participants’ relationship to treatment, and affected the temporal patterns of participants’ lives. Extending temporal relations released participants from short-term cycles of living and produced different forms of subjectivity, bringing about both transformation and loss. Monthly dosing, and a sense of normalcy characterised by absenting the routines and felt effects of drugs or treatment medications, potentiated a feeling of stability for many participants. For some, disrupting daily routines precipitated disconnection from treatment and social care relations. The transition from daily to monthly dosing required adaptation and new ways of engaging with treatment and care, with medication acting as a bridge to care without necessarily being the focal point.
Conclusions: As BUP-XR treatment gains traction internationally, it will be important to attend to the multiple, and sometimes unexpected, effects this intervention makes in the social and material lives of clients. How choice, social connection, and care can be maintained to help secure BUP-XR’s longer-term impact, and how clients can be supported to adjust to what is felt to be a new normal, will be considerations in future treatment delivery.