title: Stuck in limbo: illicit drug users' experiences with opioid maintenance treatment and the relation to recovery.
abstract: OBJECTIVE
  The objective of this article is to gain insight into how individuals who frequent open illicit drug scenes experience opioid maintenance treatment (OMT) and investigate how this appears to affect their recovery processes.
  
  
  METHODS
  By means of the ethnographic method, one of the researchers spent time in an open illicit drug scene over a 1-year span, and gathered data on individuals who frequent the scene on a regular basis, and their experiences with OMT. The data are based on field notes and audiotaped interviews.
  
  
  RESULTS
  Four themes emerged as relevant for the participants' experiences with OMT: 1) the loss of hope, 2) trapped in OMT, 3) substitution treatment is not enough, and 4) stigmatization of identity.
  
  
  CONCLUSIONS
  The participants found the OMT to be overruling and degrading. Several of the individuals from the illicit drug scene are part of the OMT programme, but as the treatment does not remove painful emotions, they supplement OMT with illegal substances, violate the OMT regulations, and run the risk of being excluded from the programme. In fear of losing the replacement opioid, they conceal parts of the addiction they seek treatment for and end up lying and cheating instead of exploring strategies for reducing and managing the addiction. The patients' relation to the OMT personnel is negatively affected by the need to hide a large portion of their issues. The result is a feeling of hopelessness, increased stigmatization, lack of control and being trapped between two worlds-in limbo, an intermediate state which interferes with the recovery process.
authors.affiliation: Department of Health Studies, University of Stavanger, Stavanger, Norway.
authors.forename: Trond Erik
authors.initials: TE
authors.lastname: Grønnestad
authors.affiliation: Department of Health Studies, University of Stavanger, Stavanger, Norway.
authors.forename: Hildegunn
authors.initials: H
authors.lastname: Sagvaag
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003415:Crime; D055030:Drug Users / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008605:Mental Health Services; D009294:Narcotics / Q000627:therapeutic use; D009664:Norway; D058850:Opiate Substitution Treatment; D026684:Personal Autonomy; D011369:Professional-Patient Relations; D057545:Social Stigma; D019966:Substance-Related Disorders / Q000628:therapy*
chemical_list: D013287:Illicit Drugs; D009294:Narcotics
keywords: Illicit drug scenes; OMT; cheating; recovery; stigma