Lived Experiences of Medication for Opioid Use Disorder: Clients' Perspectives on Formulation and Treatment

An estimated 2.7 million people in the United States ages 12 years and older suffered from opioid use disorder (OUD) in 2020; during the same period, approximately 68,000 people died due to an opioid overdose. In recent years, with support from federal funding, medication for opioid use disorder (MOUD) has emerged as a viable treatment option. The partial-opioid-agonist buprenorphine/naloxone (brand name, Suboxone) is the most used MOUD and is commonly administered as a daily oral dose. Naltrexone is an opioid antagonist primarily administered as a slow-release monthly injection formulation (brand name, Vivitrol).

This study aimed to explore clients' perceptions and experiences of using oral Suboxone and injectable Vivitrol for OUD treatment.

This was a cross-sectional qualitative study.

We conducted semi-structured interviews with 65 clients from 2 residential treatment facilities in Tennessee between August 2019 and October 2020. Data were analyzed in Dedoose qualitative software using thematic analysis.

Clients shared perspectives on facilities' tapering protocols for Suboxone and generally considered the lack of tapering a favorable attribute for Vivitrol. Both prescriptions were praised for reducing opioid cravings. Pharmacological side effects sometimes hindered clients' ability to continue MOUD treatment and were more common with Suboxone. Clients reported that MOUD gave them confidence and helped them focus on treatment, though concerns were raised about Suboxone's capacity for diversion, the cost of continuing Vivitrol, and the possibility of backsliding when the MOUD prescription was complete. Participants' views on MOUD ranged from enthusiastic to stigmatizing.

Our study provides valuable insights drawn from clients' experiences using oral and injectable MOUD in substance use treatment facilities. The findings will be useful for healthcare providers and policymakers to consider the pros and cons of these medications in substance use treatment settings.