Sammendrag
The opioid antagonist extended-release naltrexone (XR-NTX) blocks the effects of opioids for four consecutive weeks, and is a novel approach in the treatment of opioid use disorder (OUD) in Norway. While many studies have shown XR-NTX to be a safe and feasible treatment for OUD, less is known about how patients experience this treatment.
This thesis aimed to deepen the understanding and knowledge of the treatment- and recovery process of people with OUD in XR-NTX treatment. Utilizing a mixed methods approach with both qualitative and quantitative methods, experiences with the treatment, as well as the personal recovery process among people participating in a large multicenter study of XR-NTX treatment in Norway (the NaltRec study) were explored.
Key findings include that XR-NTX treatment involves both benefits and challenges, and that blocking the effects of opioids does not solve all negative issues associated with opioid use. For example, patients may struggle with difficult emotions and non-opioid substance use. There was an overall increase in experienced personal recovery during treatment; however, patients followed different treatment trajectories. Various factors, both positive (such as social support) and negative (such as craving or emotional distress) are associated with personal recovery trajectory. The thesis highlights the importance of accompanying treatment with appropriate and individualized support.
Overall findings suggest XR-NTX should be delivered as part of a flexible, individualized, long-term treatment approach, and point to important focus areas for patients and clinicians, e.g. motivation for treatment, psychological distress or craving. Attention should be given to personal recovery as going beyond the current treatment episode. Awareness of factors associated with different recovery trajectories may be important to facilitate the personal recovery process.