Experiences and Perceived Social Support among Iranian Men on Methadone Maintenance Therapy: A Qualitative Study

Experiences of healthcare and substance use treatment provider-based stigma among patients receiving methadone

Background

Medications for Opioid Use Disorder (MOUD) are efficacious, however only one-third of individuals with an opioid use disorder (OUD) enter into treatment. Low rates of MOUD utilization are partially due to stigma. This study examines provider-based stigma toward MOUD and identifies factors associated with experiencing stigma related to MOUD from substance use treatment and healthcare providers among people receiving methadone.

Methods

Clients receiving MOUD at an opioid treatment program (N = 247) were recruited to complete a cross-sectional computer-based survey assessing socio-demographics, substance use, depression and anxiety symptoms, self-stigma, and recovery supports/barriers. Logistic regression was used to examine factors associated with hearing negative comments about MOUD from substance use treatment and healthcare providers.

Results

27.9% and 56.7% of respondents reported they sometimes/often hear negative comments about MOUD from substance use treatment and healthcare providers, respectively. Logistic regression results indicate that individuals who experience more negative consequences resulting from their OUD (OR=1.09, p=.019) had greater odds of hearing negative comments from substance use treatment providers. Age (OR=0.966, p=.017) and treatment stigma (OR=1.42, p=.030) were associated with greater odds of hearing negative comments from healthcare providers.

Conclusions

Stigma can be a deterrent to seeking substance use treatment, healthcare, and recovery support. Understanding factors associated with experiencing stigma from substance use treatment providers and healthcare providers is important as these individuals may act as advocates for those with OUD. This study highlights individual factors associated with hearing negative comments about methadone and other MOUD and point to areas for targeted education.

Experiences and Perspectives of Patients Treated with Methadone on Mental Health Aspect of Lifestyle: A Qualitative Study

Background: Drug abuse and its consequences place a considerable social and economic burden on society. Drug abuse has increased in Iran and reached three times the global average, indicating the need to develop innovative strategies to cope with this phenomenon. Objectives: Following a community-based participatory research approach, the aim was to identify the lived experience of drug users regarding the psychological aspect of their lifestyle. Methods: Narrative inquiry and phenomenological design were applied as the research framework. The use of in-depth interviewees and field notes guided the data collection and analysis. A total of 26 in-depth interviews were conducted with people who suffered from drug use (7 females and 19 males) in 2021. Interviewees ranging from 70 to 90 minutes were conducted in a quiet, private location chosen by the researcher. All interviews were audio-taped and transcribed, and analyzed using Colaizzi's method. Data analysis was administered using MAXQDA version 2020. Results: Most of the participants were educated Diploma and above. The participants' age ranged from 25 to 53 years old. During the interview, the subjects were in the following stages, methadone treatment time (n = 26). The analysis revealed four themes, and 11 sub-themes emerged. The themes were as follows: (1) negative emotions; (2) poor psychological capital; (3) poor support; and (4) psychological well-being. Conclusions: The most important problems of people with substance use, in the psychological dimension of lifestyle, include experiencing negative emotions, weak psychological capital, weak social support, unhealthy psychological well-being such as negative self-acceptance, reduced positive relations, not having a purposeful life, and inability to control environmental pressures. Hopefully, this study can help health policymakers develop more effective strategies against drug use.

Comparison of the effectiveness of a 12 step substance use recovery program on quality of life

Substance-related disorders can adversely impact quality of life. This study assessed a 12 step program on health-related quality of life for Iranian individuals seeking to recover from substance use. The study used a quasi-experimental, two group, three stage, pre- and post-test design and collected data at baseline, and at 1 and 3 months' post-intervention. The treatment group comprised 35 participants in a 12 step program with a non-equivalent comparison group of individuals admitted to addiction treatment centers. Physical and mental health quality-of-life domains were assessed using the Short Form 36 Health Survey Questionnaire. The treatment group improved in all aspects of health-related quality of life. The treatment group improved compared to the comparison group for two of eight quality of life dimensions - physical functioning and role limitations due to emotional problems - at 1 month post-intervention. There were additional improvements at 3 months' follow up in six of eight quality-of-life subscales compared to the comparison group. The benefits to quality of life related to mental health recovery extended beyond the treatment program, indicating that the program principles were effectively implemented in daily life.

A Qualitative Study of Iranian Parents' Experiences of Interacting With Their Adolescent Children

Introduction: Transition from childhood to adulthood is an important and challenging period for both adolescents and their parents, particularly in societies undergoing development and change. In Iran, cultural and social change is inextricably linked to, and strongly impacts on, family units. Aim: To explore the experiences of parents and the strategies they use in interacting with their adolescent children. Method: Qualitative descriptive research using in-depth interviews was conducted with 23 parents of adolescents in Iran. Transcribed data were subjected to thematic analysis. Results: Parents used two key approaches to effectively interact with their adolescent children. The first, "transformed parenting" involved the parents changing their parenting style and practices. The second approach, "child orientation" involved the parents trying to control, educate, and guide their child. Implication for transcultural practice: Understanding how parents experience interactions with adolescents in the context of Iranian culture and increasing modernity will guide nurses to foster effective parenting strategies for optimal adolescent development.

Support Needs for Family Caregivers of Clients with Mental Illness in Iran: A Qualitative Study

This paper explored the support needs of family caregivers of people living with a mental illness in Iran. This descriptive study focused on the experiences of 20 family caregivers as well as the views of 29 professional support workers through individual face-to-face interviews. From these interviews three key themes emerged in regards to the care needs of family caregivers: (i) social support; (ii) emotional support; and (iii) safety and security. These themes highlighted the complex role of caring for a family member with a mental illness and the emotional, social and economic challenges that these caregivers experienced as a result. Iranian caregivers garnered support not only from other family members but also from neighbors and religious leaders but lacked the much needed respite care found in western countries. This research study highlighted the importance of ensuring that the caregivers themselves receive appropriate and adequate support to fulfill their caregiving role.