Being Seen and Heard: Exploring the Relational Dimension of Heroin Assisted Treatment in Norway.

Background

This ongoing qualitative study examines the newly established Heroin Assisted Treatment (HAT) in Norway, aimed at individuals with severe Opioid Use Disorder (OUD) who haven't benefited from traditional opioid maintenance treatment. Initiated in 2022, HAT marks a shift from a conservative treatment approach to a person-centered approach in Opioid Addiction Treatment. In addition to providing medical care and medicine, HAT fosters a social environment where daily interactions occur among staff, patients, and their peers. This research focuses on these relational dynamics, investigating their potential in de-stigmatizing the patients and influencing patients' self-perception and identity.

Methods

The research employs qualitative methods, including 65 semi-structured interviews with 27 unique HAT patients in Oslo and Bergen. The study has a longitudinal design, where patients has undergone multiple interviews over the course of two years. This captures the narratives of change and self-reflection over time, as the clinic routines and practices also are subject to change. Ethnographic field work has also been conducted in both clinics.

Results

The study's preliminary shows a high level of satisfaction among HAT patients, primarily attributable to the medical heroin in combination with the staff's empathetic and competent approach to the patients. A crucial aspect of this satisfaction is the frequent interaction between patients and healthcare providers (nurses and social workers), which becomes particularly important as patients experience increased free time due to the structured heroin provision. Based on the personal relationship between the staff and the patients, the staff can therefore suggest personalized types of meaningful activities or work to do in the patients newly acquired spare time. Patients report that it is important to fill this time to improve their quality of life, when their medical needs are met. The program's intent of transitioning patients to a new lifestyle therefore hinges on these relationships. To facilitate the adjustment to the new lifestyle, HAT staff actively link patients to organizations offering practical, cash-in-hand work or leisure activities, thereby promoting a balanced and enriching lifestyle.

Conclusion

These early findings point to HAT in Norway as a potentially transformative healthcare approach, offering patients the opportunity to reshape their lives and habits. The relational interactions, especially with staff, are crucial for patient comfort and consistent treatment engagement. The program's structure, including leisure and employment facilitation, addresses life changes constructively. While these initial results are promising, the complexity of HAT's logistical and regulatory aspects calls for continuous evaluation and adaptation to maximize its effectiveness and accessibility.