ABSTRACT

Katariina Aarros and Heidi Wakkinen Experiences of clients in opioid substitution treatment with harm-reduction goals 42 p., 5 appendices Spring, 2023 Diaconia University of Applied Sciences Bachelor's Degree in Health Care Registered Nurse

The purpose of this thesis was to describe the experiences of clients in harm-reducing substitution treatment, on the effects of the substitution treatment on physical, mental, and social functioning. The aim of the thesis was to increase the understanding of harm-reducing substitution treatment and gain knowledge of substitution treatment and its perceived effects on functional capacity. In addition, the aim was to make the voice of the clients undergoing substitution treatment heard and to give them the feeling that their experiences are meaningful. The thesis was a qualitative study carried out in cooperation with the Rinnekodit substance abuse service unit of the Deaconess Institute Group Breikki Helsinki in the spring of 2023. Thematic interviews were used as the data collection method. The interview framework included key themes and clarifying questions. The qualitative data was mainly analysed using inductive content analysis, but there were also abductive elements in the analysis. A total of four interviewees participated in the study. The main issues highlighted in the data were a clear decrease in injecting drug use and the consequent low number of infections. The treatment strengthened mental functioning, and the clinic's psychosocial support was seen to have increased resources. Suicidal thoughts and the risk of their acting on them had decreased. The treatment was felt to facilitate supportive planning and decisionmaking. The decisions were also thought to be more sensible than before. Treatment fatigue was touched upon in some form by all interviewees. Substitution treatment was considered to have had the greatest impact on social functioning, where improved relationships with family and friends were the most important effects. Substitution treatment enabled work activities and voluntary activities. The importance of the community in the treatment was seen as a resource. Poor treatment had been experienced in public services, especially in health services was emphasised here.

Keywords: opiates, opioids, methadone, buprenorphine, substitution therapy, functional capacity