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However, the experiences of patients initiating MMT have been overlooked in the literature. This study explores experiences of MMT initiation among MMT patients, focusing on contextual influences on MMT initiation and perceptions of MMT and their subsequent influence on treatment retention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Semi\u2010structured qualitative interviews were conducted with 39 MMT patients in Vancouver, Canada. Individuals reporting enrolment in MMT were recruited from within two ongoing cohort studies comprised of people who use drugs. Interview transcripts were analysed using an inductive and iterative approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two groups of MMT initiators were identified: (i) \u2018crisis initiators\u2019 prescribed methadone following critical transition events, such as incarceration or pregnancy; and (ii) \u2018everyday initiators\u2019 enrolled in MMT as part of routine healthcare utilisation. While most \u2018crisis initiators\u2019 and some \u2018everyday initiators\u2019 described experiencing coercion during MMT initiation, \u2018crisis initiators\u2019 were further subjected to the coercive leveraging of their vulnerability to motivate \u2018consent\u2019 for MMT. \u2018Crisis initiators\u2019 developed negative views towards MMT and were more likely to discontinue treatment. Long\u2010standing patient\u2013provider relationships and open dialogue were associated with more positive views regarding MMT, regardless of the circumstances of initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusion<\/jats:title><jats:p>Findings underscore the need for clear and effective communication regarding treatment regimens and expectations during MMT initiation. Furthermore, training in trauma\u2010informed care may help reduce perceptions of coercion and rates of early treatment termination. [Damon W, Small W, Anderson S, Maher L, Wood E, Kerr T, McNeil R. Crisis\u2019 and \u2018everyday\u2019 initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation. Drug Alcohol Rev 2017;36:253\u2013260]<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.12411","type":"journal-article","created":{"date-parts":[[2016,4,30]],"date-time":"2016-04-30T11:15:29Z","timestamp":1462014929000},"page":"253-260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["\u2018Crisis\u2019 and \u2018everyday\u2019 initiators: A qualitative study of coercion and agency in the context of methadone maintenance treatment initiation"],"prefix":"10.1111","volume":"36","author":[{"given":"Will","family":"Damon","sequence":"first","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Small","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solanna","family":"Anderson","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Maher","sequence":"additional","affiliation":[{"name":"Kirby Institute of Infection and Immunity UNSW Australia  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Wood","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kerr","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"McNeil","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2008.11.004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5945"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12682"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.09.435"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02856.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02249.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta11090"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/630209"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.02905.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02269.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826087009057010"},{"key":"e_1_2_7_13_1","first-page":"256","volume-title":"Theories on drug abuse: selected contemporary perspectives","author":"Dole VP","year":"1980"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.800119"},{"key":"e_1_2_7_15_1","unstructured":"ReistD.Methadone Maintenance Treatment in British Columbia 1996\u20132008: Analysis and Recommendations. 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