ArticleThe International journal on drug policy2020
Motivations to initiate injectable hydromorphone and diacetylmorphine treatment: A qualitative study of patient experiences in Vancouver, Canada.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- "With this you're not chained down to something": contrasting experiences of opioid agonist treatment and safer supply program participation among people receiving prescribed safer supply.Harm reduction journal · 2026Article
- Hydromorphone Hopes: A Qualitative Study of People Initiating Supervised Short-Acting Injectable Opioid Treatment in Australia.Drug and alcohol review · 2025Article
- Reimagining subjectivities in place: Necropolitical logics of safer supply and housing in Vancouver's Downtown Eastside.Social science & medicine (1982) · 2025Article
- "I still can feel the sickness": Withdrawal experiences of people on methadone maintenance treatment.Journal of substance use and addiction treatment · 2025Article
- Challenges for the implementation of injectable opioid agonist treatment: a scoping review.Harm reduction journal · 2024Article
- "They talk about it like it's an overdose crisis when in fact it's basically genocide": The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood.The International journal on drug policy · 2024Article
- Preferred pharmaceutical-grade opioids to reduce the use of unregulated opioids: A cross-sectional analysis among people who use unregulated opioids in Vancouver, Canada.The International journal on drug policy · 2024Article
- Using alone at home: What's missing in housing-based responses to the overdose crisis?Harm reduction journal · 2024Review
- Patients' satisfaction with heroin-assisted treatment: a qualitative study.Harm reduction journal · 2023Article
- A Structural Competency Framework for Emergency Medicine Research: Results from a Scoping Review and Consensus Conference.The western journal of emergency medicine · 2022Article
- Acute pain and self-directed discharge among hospitalized patients with opioid-related diagnoses: a cohort study.Harm reduction journal · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWithin the context of the ongoing overdose crisis and limitations of conventional opioid treatments, the scale-up of injectable hydromorphone (HDM) and diacetylmorphine (DAM) as evidenced-based treatments is currently underway in some settings in Canada. Past research has underscored the importance of treatment initiation in shaping onward treatment trajectories, however structural factors that influence participants' motivations to access injectable HDM or DAM have not been fully characterized. This study examines peoples' motivations for accessing HDM/DAM treatment and situates these within the social and structural context that shapes treatment delivery by employing the concept of structural vulnerability.
methodsFifty-two individuals enrolled in injectable HDM/DAM programs were recruited from four community-based clinical programs in Vancouver, Canada to participate in qualitative semi-structured interviews. Approximately 50 h of ethnographic fieldwork was also completed in one clinical setting, and one-on-one with participants public spaces. Interview transcripts and ethnographic fieldnotes were analyzed through a structural vulnerability lens with a focus on treatment initiation.
resultsParticipants' previous experiences and perceptions of other drug treatments (e.g. methadone) foregrounded their initiation of injectable HDM/DAM. Social and structural factors (e.g. fentanyl-adulterated drug supply, poverty, drug criminalization) influenced participants' motivations to address immediate physical risks and their initial perception of this treatment's ability to align with their opioid use experiences. Similar social and structural factors that drive immediate physical risks, were also evidenced in participants' motivations to make changes in their daily lives and to address broader opioid use goals.
conclusionParticipants descriptions of their motivations to initiate HDM/DAM highlight how structural vulnerabilities shaped participants' experiences initiating injectable HDM/DAM.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.