New research based on the experiences of people on long-term methadone programmes has found that while it has provided stability and improved health, the time spent on the programme meant some found their "lives were on hold".
One former heroin user interviewed for the study said methadone was "stalling" the problem "but not fixing it".
According to the study, published in the: "At the core of these narratives was a perceived absence of a path, with a large number articulating a sense of being ‘stuck’ or trapped in a cycle that did not lead to progress or change."
The research was carried out by Paula Mayock, assistant professor and director of teaching and learning postgraduate at the School of Social Work and Social Policy at Trinity College Dublin, and her colleague Shane Butler.
It looked at the experiences of 25 long-term methadone maintenance treatment (MMT) clients in the Greater Dublin Area.
The average age of the 16 men and nine women in the sample was 43. Few were working full-time and six had no formal educational qualifications. Over half of the study’s participants, the majority of them male, had experienced homelessness at some point in their lives.
"The vast majority of study participants reported that methadone treatment had impacted their lives positively in at least one respect," it said.
"The most commonly stated benefit being that methadone brought stability and normality to their lives."
Other benefits including allowing some to engage more positively with their families and children. Male participants, in particular, also noted how that stability meant a specific link to a reduction in criminal activity.
One methadone client said he had less "strife" as he no longer had to steal to finance his drug use. Others also cited health benefits from being on methadone.
However, the long-running methadone programme regime and the apparently slim prospects of moving on from it were also mentioned by those who were interviewed.
One of 16 participants who first accessed treatment more than 20 years previously, Bernie said she felt “hostage” to MMT and described a routine of being “oiled up” in order to start her day.
"But like, it’s like you’re held hostage by this green substance," she said. "Like the Tin Man has to take his oil before he starts his day."
Another client called Dillon, in his 30s, said:
Participants also described "barriers" in other aspects of their lives. Some requested a reduction in their daily dose but said this request was viewed negatively or refused without a full or detailed discussion of the pros and cons.
Very few were seeking employment and one factor was "the challenge of potentially having to balance the demands of MMT with those of maintaining employment".
One client said: “If you’re on methadone you need to take time off to get your script, to go to the chemist, you know, and these cause terrible issues.”
Dr Mayock said methadone is shown to have numerous benefits, but added: "We argue that Irish drug policy falls very far short of its stated aim of moving methadone patients along a pathway to social reintegration/recovery."