Table 1.

Select Participant Statements Describing the Four Factors That Shape Perspective of Care

FactorsParticipant Statement
Societal structures“I'm about to lose Medicaid because I make too much money [working at McDonalds] and I will have to pay for it.”
“I have to drive from Tennessee [in order to receive treatment].”
“The only clinic for treatment in my home town doesn't accept Medicaid.”
“My past is my past, people [including healthcare providers] tend to look down on you.”
Life before treatment“I was not in a good place before coming here.”
“I was hanging out with people I should not have.”
“I had never been addicted to anything before except smoking… being addicted to narcotics made me feel like a bad mother.”
“My life is more in control [now].”
“I'm not a horrible person anymore.”
“I'm a great person in society instead of a bad one.”
Treatment history[You can] get more drugs there than anywhere. You can get anything standing in line at the clinic.”
“Everyone knows your business there, they may not tell it but they know it.”
Still going to a drug dealer.”
“No freedom, no life, they don't care about you.”
“Don't have to come every day.” [previous care at Opioid Treatment Program]
“You have to come often” [no previous treatment]
Experiences in office-based opioid treatment[If it wasn't for the staff here] I'm not sure what I would have done.”
“[They] make you feel more human here than other places.”
[I can get care] all in one place.”
“Superman cape.”
[I've] woken up.”
“It's a world of difference to wake up and feel good.”