An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment

An occupational justice perspective of people’s experiences while on Methadone Maintenance Treatment Purpose A study was undertaken with people on Methadone Maintenance Treatment (MMT) in London, Ontario. Given that MMT is time intensive, the objectives were to better understand the experiences and daily routines of people on MMT through in-depth exploration of their everyday occupations and the ongoing challenges and barriers they face to accessing treatment. Methods We used a qualitative intrinsic case study methodology (Stake, 1995) informed by the framework for occupational justice (Stadnyk et al., 2010; Townsend, 2012). Participants: Three females and two males between the ages of 27 and 42 who had been on MMT for at least one year. Data collection: Two sessions were conducted with each participant. The first consisted of a semi-structured interview, the creation of an occupational map (Huot & Laliberte Rudman, 2015) and completion of a demographic questionnaire. The second entailed a follow-up interview. Data analysis: Data analysis entailed whole text analysis and line-by-line coding of the ten transcripts. The analysis of the visual data generated through mapping also informed the findings. Results Four themes highlighting key aspects of the participants\u27 experiences will be presented. First, findings outline a ‘descent into chaos’ as participants’ addictions began and worsened over time. Second, participants’ experiences of ‘MMT as a bridge’ to recovery from addiction are described. Third, a ‘new normal’ daily life that is characterized by liminality is shown to be linked to people’s experiences on MMT. Finally, participants’ hopes for ‘moving forward’ are outlined. These themes in the data suggest that participants do not follow a strictly linear route but generally shift from chaos to boredom with the ever present possibility of relapse. Implications for occupational science In relation to the framework for occupational justice, the findings illustrate how structural factors such as health and community supports, and income supports as well as contextual factors including income/wealth, employment status, homelessness, and family/friend support interact to create occupational outcomes contributed to the participants’ experiences of occupational imbalance and occupational marginalization. MMT is not strictly an \u27individual\u27 experience, rather it is shaped by broader factors, which leads people in treatment to experience particular occupational injustices. Thus, MMT practices and policies should consider the occupational implications to enhance clients’ experiences and further support their recovery. Discussion questions How might comparative research help further illuminate the challenges faced by MMT clients? (e.g. urban/rural) How could MMT policies and practices be adapted to reflect the occupational implications discussed and to enhance clients\u27 experiences? How might other occupational science concepts be used to conduct additional research with people on MMT