Connecting and disconnecting: Experiences of people with opioid use disorder in intensive outpatient treatment

Abstract

INTRODUCTION: Opioid use disorder (OUD) is a public health crisis affecting 2 million Americans. Approximately 80% of people with OUD do not receive treatment, and attrition rates in treatment programs are as high as 80%. Previous research has shown intensive outpatient treatment (IOT) has positive outcomes, but enrollment and retention in programs are problematic. To improve outcomes and increase engagement, more information is needed about how persons experience IOT programs. The purpose of this study is to describe processes that people with OUD undergo as they participate in IOT programs. METHODS: The research team conducted a constructivist grounded theory study in IOT programs at two adult academic health centers within a large Midwest health care system. Study staff conducted interviews with 14 persons to elicit narratives about their experiences in the IOT programs. The team transcribed and analyzed interviews using a four-step process consistent with grounded theory methods. RESULTS: Participants described the process of connecting and disconnecting as central to their IOT experience. The process included eight stages: (1) connecting with drugs, (2) disconnecting from everyday life, (3) connecting with the IOT program, (4) connecting with others in the IOT program, (5) disconnecting from drugs, (6) reconnecting with others, (7) reconnecting with self, and (8) disconnecting from the IOT program. CONCLUSIONS: Connections with the IOT program, other patients, and IOT staff are central to beginning sobriety. Findings indicate that clinicians should foster connections and provide a multi-dimensional experience that enables patients to begin recovery.