The study aims to provide insight into the lives of parents to adult children with drug addiction. We focus on how the parents' social life and interactions were affected by feelings of guilt and shame, and how they dealt with the stigma that often accompanies drug addiction. 32 semi-structured interviews were conducted with parents (age 46-70) of adult children (age 18-47) with drug addiction in Sweden. Three themes emerged (1) Experiences of guilt, shame, and courtesy stigma, (2) Impact on social life and relationships and, (3) Strategies to reduce guilt and shame. Guilt, shame, and courtesy stigma complicated and restricted the parents' social interactions. Many parents applied a selective openness, carried experiences of alienation and in some cases isolated themselves. At the same time, several parents described that they were open about their child's addiction in certain contexts. For some parents, this meant a relief from guilt and shame and an opportunity for increased social interaction. Both informal and professional support for family members of individuals with drug addiction is vital to reduce experiences of guilt, shame, and courtesy stigma.

BACKGROUND: Recently developed buprenorphine depot injections have the potential to reduce risk for diversion and misuse, and to increase adherence with fewer visits for supervised intake. However, it is unclear how patients perceive this new form of medication. The purpose of this study was to explore patients' experiences of depot injections and their reasons for continuing, discontinuing, or declining depot injection treatment.

METHODS: We conducted semi-structured qualitative interviews with 32 people, 14 of whom had ongoing depot injection treatment, 11 who had discontinued depot-injections and switched to other medication and seven who had declined treatment with depot formulations. Interviews were transcribed, coded, and analysed using NVivo, based on this overall stratification into three participant groups.

RESULTS: The main categories relate to the effects and side effects of the depot formulation, social and practical factors, psychological benefits and disadvantages, and interactions with treatment staff. Social and practical factors were of importance for choosing depot formulations, such as increased freedom and their making it easier to combine treatment with work and family life, as well as psychological advantages including "feeling normal". Initial withdrawal symptoms that resolved themselves after a number of injections were reported by most participants. Reliable information and patient-staff relationships characterized by trust helped patients to cope with these initial problems. Those who discontinued treatment often did so near the beginning of the treatment, reporting withdrawal symptoms and insufficient effects as the main reasons. Coercion and insufficient information contributed to a negative pharmaceutical atmosphere at one of the clinics, which may have adversely influenced perceptions of depot formulations and decreased willingness to accept and continue treatment.

CONCLUSIONS: Buprenorphine depot injections may have social, practical, and psychological benefits compared to other formulations. However, depot injections are not perceived as an attractive option by all patients. Trust, consistent and adequate information, and awareness of the implications of the pharmaceutical atmosphere should be considered when introducing new medications.

In this study we analyze how parents of adult children with drug use problems view the initial stages of identifying their children's troubles as a severe drug problem. We focus on the parents' accounts of the discovery process by identifying significant events in the parents' narratives through 'the micro-politics of trouble'. The study is based on an analysis of 32 semi-structured interviews with parents of adult children (aged 18+) with drug problems. Four themes emerged from the parents' narratives: (1) the first signs of a problem, (2) drug problem or teenage defiance? (3) the awakening, (4) a passing phase. The different themes show how the parents' interpretations of the situation influence their definitions and thus their actions. Early signs and indicators of something being wrong do not initially result in parents framing the situation as problematic as they are perceived as everyday concerns and dealt with as such. Our focus on the initial phase of the problem definition process and how this affects the parents may provide a better understanding of the parents' situation and needs for support. This may be of use to professionals in the fields of social work and drug treatment who meet these parents and may have a role to play in the development of support measures that can improve their situation.