Experiences of Suboxone treatment in WA, Victoria and NSW….some unintended effects of policy

  • Ms Amanda Morris, The Langton Centre,NSW, Australia
  • Ms Kristie Mammen, The Langton Centre,NSW, Australia
  • Ms Suzanne Robinson, New South Wales Users and AIDS association,NSW, Australia
  • A/Prof James Bell, The Langton Centre,NSW, Australia
  • Doctor Allan Quigley, Next Step,WA, Australia
  • Doctor Nick Lintzeris, Sydney South West Area Health Service,NSW, Australia
  • Ms Anni Ryan, The Langton Centre,NSW, Australia
  • In this paper we discuss limitations and gaps in current policies for the use of buprenorphine-naloxone (Suboxone) in Victoria, NSW and WA. A Commonwealth Government funded study explored the implementation of Suboxone in these states using mixed methods, including consumer and prescriber focus groups as well as in-depth interviews. A discursive analysis of the data was informed bypostructuralist principles and ideas from grounded theory. Preliminary data revealed that while consumers and prescribers often ‘sung the praises’ of Suboxone, other less acceptable effects of the current Suboxone treatment policies were also apparent. In WA themes of ‘surveillance’ and ‘being watched’ emerged in consumers’ accounts of their experience of supervision of Suboxone treatment. The effect of this on consumers who described themselves as ‘going well’ was the expression of resentment towards others they defined as ‘junkies’. Both consumers and prescribers advocated for a more flexible takeaway policy.In NSW themes of ‘being different’ to other consumers and ‘falling through the gaps’ emerged. The later came from accounts of consumers who had had experienced long term daily supervision at a public clinic before receiving weekly TA’s. Expressed was a tension between the desire to maintain a flexible TA regime and the need for additional support. Strong ‘othering’ of people on methadone served to squash any suggestion that going back onto Methadone could be a more suitable option. In Victoria (Max=5days TA) consumers and prescribers voiced a need for more support. In contrast to the other states there was a strong sense of personal agency emerging from some consumers accounts of how they were able to mould the programme to fit with their own needs.