Exploring the Concepts of Abstinence and Recovery Through the Experiences of Long-Term Opiate Substitution Clients

Subst Abus. 2015;36(2):232-9. doi: 10.1080/08897077.2014.941085. Epub 2014 Aug 15.


Background: This study aimed to explore the client experience of long-term opiate substitution treatment (OST).

Methods: A qualitative grounded theory study set in a U.K. rural community drug treatment service.

Results: Continuous OST enabled stability and a sense of "normality." Participants expressed relief at moving away from previous chaotic lifestyles and freedom from the persistent fear of opiate withdrawal. However, for some, being on a script made them feel withdrawn, lethargic, and unable to fully participate in mainstream society. Intrapersonal barriers (motivation and fear) were perceived as key barriers to abstinence.

Conclusions: Participants experienced long-term OST as a transition between illicit drug use and recovery. Recovery was seen as a process rather than a fixed goal, confirming that there is a need for services to negotiate individualized recovery goals, spanning harm minimization and abstinence-oriented treatment approaches.

Keywords: Opiate addiction; opiate dependence; opiate substitution treatment; qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Buprenorphine / therapeutic use*
  • Fear / psychology
  • Female
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • Motivation
  • Opiate Substitution Treatment / psychology*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / psychology*
  • Qualitative Research
  • Rural Population
  • Substance Withdrawal Syndrome / psychology*


  • Analgesics, Opioid
  • Buprenorphine
  • Methadone