What are the reasons for injected methadone use? A qualitative study of people who use drugs parenterally in Barcelona.

Abstract

Oral methadone maintenance is a widely adopted and effective treatment for heroin and other opioid dependencies. However, injectable methadone usage may pose greater risks than heroin itself. Despite decades of oral methadone treatment in Spain, there is limited understanding of the motivations for parenteral consumption. This study aimed to examine the reasons for methadone injection, delineate its specific advantages and disadvantages compared with those of heroin use, and assess the benefits and drawbacks of supervised methadone injection within a harm reduction service from the perspective of people who inject drugs. A qualitative phenomenological study was conducted in 11 patients at a safe injection facility in Barcelona. Semistructured interviews revealed that the reasons for injecting methadone were its provision of a euphoric rush, the pleasurable sensation of needle insertion, and the avoidance of gastrointestinal discomfort associated with oral methadone use. The main attraction of methadone injection was its accessibility as a legal and fully state-funded treatment option in Spain, coupled with its effectiveness in relieving withdrawal symptoms. However, notable disadvantages included the risks inherent in injection. The benefits of supervised consumption rooms were its provision of immediate medical assistance in overdose situations, ease of access, and physical safety. Drawbacks included waiting times, limited opening hours, neighborhood stigmatization, and the distance people who inject methadone had to travel when obtaining methadone from the illicit market. Based on these findings, we make several recommendations aimed at reducing the harm associated with methadone injection and emphasize the need for comprehensive harm reduction strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).