Abstract
BACKGROUND: According to the International Classification of Diseases (ICD-10), a client using substitution is abstaining, while in the context of group psychotherapy, such a client tends to be considered not to be abstaining. Our clinical experience shows that this contradiction is particularly noticeable in aftercare facilities'approach to accepting clients on substitution.
OBJECTIVES: The aim of this paper is to describe the approach of aftercare facilities to clients using buprenorphine substitution and evaluate such clients' chances of entering and staying in aftercare treatment programmes. METHODS: Data were obtained using an electronic questionnaire and semi-structured telephone interviews.
The data were subsequently recorded into a Microsoft Excel spreadsheet and processed using the method of qualitative analytic induction. SAMPLE: The sample, selected by the method of total selection, includes 14 certified aftercare facilities in the Czech Republic.
RESULTS: In the Czech Republic, there are three aftercare facilities which normally offer their services to clients using substitution. The most common obstacle to the perception of clients using substitution as abstaining is the view of substitution treatment as irregular treatment.
CONCLUSIONS: Only a few facilities are following the ICD-10 diagnostic guidelines for the correct classification of clients using substitution into the category of abstaining in clinically monitored or substituted mode". The secondary, but equally important, outcomes of this research include the emerging questions concerning the reasons for such an approach on the part of most of the facilities, or the motivation of the individual staff members.