Table 3 Most prevalent disadvantages and illustrative excerpts

“No disadvantages”

-

10 (4%)

-

4 (2%)

-

19 (9%)

24 (10%)

Creates a long-term dependency

“If you stay on it for years, it never gets them off the dependence.”

45 (19%)

“Methadone is often referred to as ‘liquid handcuffs’ because clients must travel to and from the clinic daily to receive it and ‘take home doses’ are difficult to earn…”

47 (20%)

“A person can become dependent upon it.”

12 (6%)

74 (30%)

Side effects

“Sedation, nausea, vomiting, itching.”

35 (15%)

“Long-term side-effects; damages teeth”

42 (18%)

“Nausea, headache, dizziness”; “stomach pain”, “fever”, “allergic reactions”.

38 (17%)

70 (28%)

Inconvenient

“Having to see the doctor so much because it is so regulated”

13 (5%)

“It’s a daily commitment to go to the clinic.”

68 (29%)

“You CAN’T [sic] miss that appointment.”

4 (2%)

68 (27%)

Specific misuse

“[Buprenorphine] is a divertible medication and is frequently diverted as we are learning from our clients. This means they may not use it properly and instead use it to support their ongoing addiction to fentanyl.”

20 (9%)

“Patient would use other substances to intensify the effects of the medication to continue use drugs or sell their medication.”

24 (11%)

“You can overdose if you try to get high when using it”

9 (4%)

42 (17%)

Medication adherence or maintenance difficult

“The most important part is keeping up with the prescription and keeping the re-fills.”

24 (11%)

“Must be dosed every day and if a dose is missed, then the patient can withdrawal and have a lot of issues. Many patients cannot keep up with it because it does have to be dosed daily.”

14 (6%)

“Once [on a] starting regimen many patients don’t keep up with their monthly appointments.”

16 (8%)

39 (16%)