The social, material and temporal effects of extended-release buprenorphine depot treatment for opioid dependence: an Australian qualitative study

Background: This study aimed to examine the multiple social, material and temporal effects of extended-release buprenorphine depot (BUP-XR) treatment in clients’ lives, among a group of participants receiving BUP-XR in Australia, and consider the situated potentials of these new opioid agonist treatment technologies.

Methods: Using a longitudinal qualitative design, 36 participants (25 men, 11 women; mean age 44 years) were interviewed, generating accounts of BUP-XR treatment experiences at two time points. Analysis was informed by sociological approaches which attend to the multiple effects of novel health intervention technologies as they are put to use and made to work in sites of implementation practice, with a focus on tracing change over time.

Results: The shift from daily to monthly dosing altered how opioid agonist treatment was experienced, reconfigured participants’ relationship to treatment, and affected the temporal patterns of participants’ lives. New temporal relations released clients from short-term cycles of living and produced different forms of subjectivity, bringing about both transformation and loss. The transition from daily to monthly dosing, and a sense of normalcy characterised by absenting the routines and felt effects of drugs or treatment medications, potentiated a feeling of stability for many. For some, disrupting daily routines precipitated disconnection from treatment and social relations. The transition from daily to monthly dosing required adaptation and new ways of engaging with treatment and care.

Conclusion: As BUP-XR treatment gains traction internationally, it will be important to attend to the multiple effects this intervention makes in specific sites of practice, recognising that the promise of new treatment technologies entangles with their social and material environments and clients’ lives. How choice, social connection, and care can be maintained, and how clients can be supported to adjust to what is felt to be a new normal, will be a key consideration for services.