Drug-Related Harm According to Opiate Users on Buprenorphine Treatment

Abstract

Aims The purpose of this article is to analyse the meanings given to substances as intoxicants, medicine and treatment from the client perspective in buprenorphine treatment. How do the clients construct drug-related harms and how do they act to reduce the harms? Methods The material is ethnographic and consists of participant observation and client interviews. The data is gathered from an institutional treatment facility offering buprenorphine treatment. Clients stressed the excitement of heroin use as opposed to the safety of buprenorphoine. The negative aspects of amphetamins are strongly emphasised. They did not justify the need for substitution therapy. The negative effects of heroin had a dual meaning in that they also assigned a positive user identity and justified the need for medication. The safety aspect of burprenorphine was linked to nonexistent overdose risk and to difficulty in tracing the substance in urine tests. The function of burprenorphine as an intoxicant was to restrict the harm resulting from the use of other intoxicants. The clients in substitution treatment emphasised the positive effect of buprenorfine as a medicine while those in detox emphasised the negative effects. Treatment itself receives positive meaning when it offers belief in achieving the personal treatment goal and negative meaning if it fails to do so. Conclusion The dual political role of bruprenorphine as a life saving medication and an evil drug complicates the status and role of clients in buprenorphine treatment.