title: A chance to stop and breathe: participants' experiences in the North American Opiate Medication Initiative clinical trial.
abstract: BACKGROUND
  The North American Opiate Medication Initiative (NAOMI) clinical trial compared the effectiveness of injectable diacetylmorphine (DAM) or hydromorphone (HDM) to oral methadone maintenance treatment (MMT). This study aimed to determine participants' perceptions of treatment delivered in NAOMI.
  
  
  METHODS
  A qualitative sub-study was conducted with 29 participants (12 female): 18 (62.1%) received injectable DAM or HDM and 11 (37.9%) received MMT. A phenomenological theoretical framework was used. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis was used over successive phases and was driven by the semantic meanings of the data.
  
  
  RESULTS
  Participants receiving injectable medications suggested that the supervised delivery model was stringent but provided valuable stability to their lives. Females discussed the adjustment required for the clinical setting, while males focused on the challenging clinic schedule and its impact on employment abilities. Participants receiving MMT described disappointment with being randomized to this treatment; however, positive aspects, including the quick titration time and availability of auxiliary services, were also discussed.
  
  
  CONCLUSIONS
  Treatment with injectable DAM (or HDM) is preferred by participants and considered effective in reducing the burden of opioid dependency. Engaging patients in research regarding their perceptions of treatment provides a comprehensive assessment of treatment needs and barriers.
  
  
  BACKGROUND
  NCT00175357.
authors.affiliation: Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St, Paul's Hospital, 575- 1081 Burrard St,, Vancouver, BC V6Z 1Y6, Canada. eugenia@cheos.ubc.ca.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Oviedo-Joekes
authors.forename: Kirsten
authors.initials: K
authors.lastname: Marchand
authors.forename: Kurt
authors.initials: K
authors.lastname: Lock
authors.forename: Jill
authors.initials: J
authors.lastname: Chettiar
authors.forename: David C
authors.initials: DC
authors.lastname: Marsh
authors.forename: Suzanne
authors.initials: S
authors.lastname: Brissette
authors.forename: Aslam H
authors.initials: AH
authors.lastname: Anis
authors.forename: Martin T
authors.initials: MT
authors.lastname: Schechter
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D003932:Heroin / Q000008:administration & dosage*; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009656:North America; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D012107:Research Design; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D003932:Heroin; D004091:Hydromorphone; D008691:Methadone