Pathways to 'recovery' and social reintegration: The experiences of long-term clients of methadone maintenance treatment in an Irish drug treatment setting.

Introduction: This paper examines the experiences of long-term clients of methadone maintenance treatment (MMT) in one area of Dublin in the context of a recent emphasis on rehabilitation and recovery in Irish drug policy.

Methods: In-depth qualitative interviews were conducted with 25 long-term clients of methadone maintenance treatment (MMT). All participants had first enrolled in methadone treatment at least ten years prior to participating in the research and a majority (n = 16) had first accessed MMT more than 20 years previously.

Results: While acknowledging several beneficial aspects of methadone treatment, research participants saw themselves as passive recipients of a clinical regime that offered no opportunity to exercise agency in relation to their ongoing treatment. Rather than perceiving themselves as progressing along a pathway to recovery, the treatment experience was depicted in terms of stasis or confinement. Neither did participants report any progress in attaining the kind of social reintegration that is commonly presented as a key aspect of addiction recovery and which, in the Irish context, is a central plank of drug policy discourse.

Discussion: The findings highlight a disconnect between policies that ostensibly aim to promote social reintegration and recovery and the experiences of individuals who are long-term clients of MMT. Irish policy aspirations of facilitating opiate-dependent clients to progress along a pathway to recovery are difficult, if not impossible, to realise given the marginal status of addiction services within the health system and the difficulties involved in securing ongoing cooperation from other public service sectors.