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The pros and cons of supervised urine tests in opioid replacement therapy: A study of patients' experiences
Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of dependency, Psychiatric Clinic, County Hospital Ryhov, Jönköping, Sweden.ORCID iD: 0000-0002-1749-4727
Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Psychiatric Clinic, County Hospital Ryhov, Jönköping, Sweden.
Department of Social Work, Malmö University, Malmö, Sweden.
2018 (English)In: Heroin Addiction and Related Clinical Problems, ISSN 1592-1638, Vol. 20, no 6, p. 5-15Article in journal (Refereed) Published
Abstract [en]

Background and aim: In opioid maintenance treatment (OMT), drug testing is performed continuously to ensure that patients are taking their prescribed medication, and to detect whether they have taken other, non-prescribed, substances. Typically, supervised urine testing is conducted, and in Sweden such testing is often a treatment precondition. This study investigates OMT patients’ experiences of and views on supervised urine testing.

Methods: Structured interviews were conducted with 90 Swedish OMT patients. During the interview, patients were asked to say what they thought about the supervised urine tests required. The answers were then analysed through content analysis.

Results: Three main themes with sub-themes were found in the patients’ statements. 1) The consequences of the test results (sub-themes: external control can provide assurance; proven drug intake may have negative consequences for patients; proven drug abstinence can yield advantages for patients), 2) The testing procedures (sub-themes: supervised urine testing is humiliating and causes harm; how you are treated is important; clinical culture and attitudes differ; stress, pressure and anxiety – tests can be difficult to perform), and 3) The structure of the testing (sub-themes: structure is needed in life; inflexible testing schemes can interfere with treatment goals; gathering people with similar problems can be counterproductive).

Conclusions: Most interviewees found the testing functional as support or as proxy control in case of personal loss of control. However, supervised urine testing also constitutes a severe invasion of privacy. Less demeaning testing methods need to be developed and implemented.

Place, publisher, year, edition, pages
Associazione per l'Utilizzo delle Conoscenze Neuroscientifiche a fini Sociali (AU-CNS) , 2018. Vol. 20, no 6, p. 5-15
Keywords [en]
drug testing, supervised urine testing, opioid maintenance treatment, user perspective, methadone, buprenorphine
National Category
Substance Abuse
Identifiers
URN: urn:nbn:se:hj:diva-37850ISI: 000452530100001Scopus ID: 2-s2.0-85064821377OAI: oai:DiVA.org:hj-37850DiVA, id: diva2:1155758
Available from: 2018-11-01 Created: 2017-11-09 Last updated: 2019-05-27Bibliographically approved

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