Vicky Carlisle is a Phd Student at the University of Bristol, funded by the NIHR School for Public Health Research. She has a background in social care and addiction treatment services and completed her BSc in Psychology, also at Bristol, in 2017. Her research interests include opioids, systematic reviews, qualitative research methods, systems-based approaches and intervention development. She is currently conducting mixed-methods research to understand the facilitators and barriers of recovery in opioid substitution treatment to inform intervention development.
Socioecological determinants of recovery in Opioid Substitution Treatment patients: A systematic review and thematic synthesis
Aims: To understand the facilitators and barriers to recovery within opioid substitution treatment (OST) for opioid dependence.
Methods: We conducted a systematic review of primary qualitative studies conducted between 1999 and 2019, that explored the concepts of recovery and abstinence from the perspective of adults receiving OST for opioid dependence and service providers working with them (e.g. clinicians and service managers). A thematic synthesis of included studies was conducted to produce themes categorised as facilitators of or barriers to recovery within OST.
Results: 41 papers were included in the final synthesis. Most studies (25) were conducted in the USA and the UK. Preliminary findings suggest a broad range of facilitators and barriers to recovery within OST. Facilitators include supportive relationships with staff, family and friends; the return of ‘positive’ emotions and reintegration into the community. Barriers ranged from incompatible staff/service user treatment goals, low self-efficacy, the experiencing of stigma and the return of challenging emotions.
Conclusions: Diverse facilitators and barriers were identified in this review; this suggests a need for service delivery and intervention design that addresses recovery on multiple levels. By synthesising a large number of qualitative studies, we have been able to better understand the lived experience of OST from multiple perspectives. Such findings help in understanding why the recovery journey may be protracted and complex for many in OST.