Narrative transitions in methadone maintenance treatment

Abstract

Methadone substitution treatment is the predominant pharmacological treatment for heroin use, aiming to reduce harm and allow for a functional life. Through a narrative inquiry, this study contributes to the understanding of the stories of individuals on methadone maintenance treatment (MMT) in Malta. It provides insight into how individuals navigate and negotiate their MMT stories with social players, the public health system, and Maltese society, examining how these interactions influence their understanding of their patient role over time and how MMT impacts their quality of life (QOL). The Single Question (SQUIN) is employed to understand the in-depth narratives of four Maltese males and one Maltese female who have been on MMT for several years. The analysis comprised two parts: the construction of interpretive stories and a narrative analysis through the lens of the three-dimensional experience model. Participants' acknowledgement of heroin addiction led to the transition from drug addict to methadone patient, resulting in an identity change. Patient-professional relationships were pivotal, while family ties acted as a driving force for abstinence. The participants concluded that MMT bridges the gap between a past life with heroin use and a good QOL. Social reintegration through national campaigns and addressing societal perceptions of heroin use and treatment remain critical. Treatment adherence may be strengthened by the implementation of a POYC system for methadone take-home prescriptions and by addressing the needs of individuals with concurrent heroin use to ensure holistic care.