Assembling and diversifying social contexts of recovery

The dynamics of more-than-human care in depot buprenorphine treatment: A new materialist analysis of Australian patients' experiences

BACKGROUND

Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients' experiences of depot buprenorphine treatment, including how it feels within the body, experiences of dosing cycles across time, and how this form of treatment relies on wider ecologies of care beyond the clinical encounter.

METHODS

Participants were recruited from sites in Sydney, regional New South Wales, and Melbourne, Victoria, Australia. Thirty participants (16 men, 14 women) participated in semi-structured interviews. Participants had histories of both heroin and prescription opioid consumption, and opioid agonist therapy including daily dosing of buprenorphine and methadone.

RESULTS

Our analysis illuminates: (1) how patients' expectations and concerns about treatment are linked to past embodied experiences of withdrawal and uncertainty about the effectiveness of depot buprenorphine; (2) the diverse meanings patients attribute to the depot buprenorphine substrate 'under the skin'; and, (3) how depot buprenorphine is embedded within wider ecologies of care, such as counselling and social supports.

CONCLUSION

Our analysis destabilises commonplace assumptions about a linear, causal relationship between the pharmacological action of depot buprenorphine and experiences of treatment. Instead, it highlights patients' variable experiences of depot buprenorphine, tracing the everyday practices, embodied feelings, expectations and wider networks of care that shape patient experiences. We conclude with some reflections on the implications of our analysis for alcohol and other drug treatment, specifically how they might inform the design of client education materials and care.

"Self-care is being attentive to yourself": using assemblages to examine discursive-material practices of self-care among Filipino university students

PURPOSE

Researchers have observed a rise in mental health issues among university students over the course of the pandemic, in part due to the closure of schools and public spaces for wellness. Thus, the purpose of this study is to explore how students creatively reassemble their self-care practices through different objects and spaces within their homes to care for their mental health.

METHODS

Photo-elicitation interviews were conducted with ten (10) female university students from the Philippines. Photographs and interview transcripts were analysed through map-making practices and an iterative process of crafting assemblages and their cofunctionings.

RESULTS

The work-home assemblage was identified as the site of self-care, delineated by boundary-making and place-making practices and the creation of time spaces. The two major cofunctionings of the work-home assemblage were (a) caring for the self as fostering different relationalities with the self, and (b) caring for the self as copresencing with human and nonhuman others.

CONCLUSION

Findings demonstrate the importance of material and spatial relationalities in facilitating caring relational encounters with the self. Theoretical and practical implications include attuning to the existing material and spatial resources in one's environment and integrating them into one's practices of caring for the self.

Therapeutic Environments in Drug Treatment: From Stigmatising Spaces to Enabling Places. A Theory-Based Qualitative Analysis

Investigating therapeutic environments for young drug users is needed to avoid a high dropout rate due to a potential stigmatising effect of the structure of the space. In this article, we draw from three semi-structured interviews with young drug users. The interviews focused broadly on their experiences being on drug treatment and on how they experienced counselling and treatment in different spaces. The findings show that therapeutic spaces that were viewed as clinical and sterile were experienced as stigmatising, which discouraged young drug users from engaging in treatment and therapeutic processes. In contrast, therapeutic places with a homely atmosphere reduced the experience of stigmatisation, facilitated participation in treatment and helped users to relax and feel part of a community. In the analysis, we show how enabling therapeutic places with a homely atmosphere can be produced through materials, activities, and sensory processes.