Syringe Exchange Clients' Perceptions of Medications for Opioid Use Disorder

Abstract

Background: Methadone and buprenorphine are effective interventions for reducing opioid use and associated harms. Given the changing nature of illicit opioids and new medication treatment models and access points, current information is needed regarding user perceptions of these medications in order to improve enrollment and adherence. Methods: We performed qualitative semi-structured interviews (N=24) with syringe exchange program (SEP) clients in four Washington State counties. The majority of participants ( 87.5%) alluded to medications for opioid use disorder (MOUD) without prompting. We coded interviews for MOUD (any exerpts mentioning buprenorphine or methadone) and analyzed responses using an inductive approach until finalized themes were adjudicated by the study team. Results: Highly interdependent themes emerged from the data including; access, preference, addictiveness, stability and timing. Access was characterized by the need for available preferred treatments in practical proximity of SEP clients. Preference included a distinction between buprenorphine and methadone treatment when choosing a MOUD option. Timing included thoughts on both when to start MOUD and the preferred duration of treatment. The theme ofAddictiveness was characterized by the perceived likelihood of physical dependency. Lastly, MOUD was seen as a means to gain stability in the lives of interviewees. Conclusions: Opioid users accessing services at WA state Syringe Exchanges offered strong opinions regarding MOUD, even when not explicitly asked. Participant preferences may benefit MOUD treatment uptake and retention.