{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:22:38Z","timestamp":1788524558197,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,22]],"date-time":"2020-03-22T00:00:00Z","timestamp":1584835200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DA044181"],"award-info":[{"award-number":["R01DA044181"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DA033147"],"award-info":[{"award-number":["R01DA033147"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Aims<\/jats:title><jats:p>Opioid\u2010related overdoses are an epidemic in North America, prompting a greater use of medications for opioid use disorder, such as methadone. Although many people work toward overall drug abstinence while on methadone, a sub\u2010population of people with and without histories of polysubstance use engage in stimulant use while on methadone treatment. This study explores motivations for concurrent stimulant and methadone use in a street\u2010involved drug\u2010using population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Semi\u2010structured qualitative interviews were conducted with 39 people on methadone in Vancouver, Canada. Participants were recruited from among the participants in two community\u2010based prospective cohort studies consisting of HIV\u2010positive and HIV\u2010negative 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>Our analysis identified three primary themes. First, participants articulated how stimulants were used to counter the sedating effects of methadone and enable them to engage in daily and survival activities (e.g. income generation). Second, participants described increased stimulant use to compensate for reduced stimulant intoxication while taking methadone. Finally, participants described the desire to achieve intoxication on stimulants once stable on methadone, as their substance use treatment goals did not involve drug abstinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusion<\/jats:title><jats:p>Among a street\u2010involved drug\u2010using population in which people do not have abstinence\u2010based treatment goals, there are several functional reasons to use stimulants concurrently while on methadone. A deeper and more nuanced understanding of substance use motivators may contribute to further research and inform policy and guideline changes that support low threshold and harm reduction\u2010focused methadone treatment programs and other interventions to reduce drug\u2010related harms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13049","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T03:13:02Z","timestamp":1584933182000},"page":"209-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Understanding concurrent stimulant use among people on methadone: A qualitative study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-7693","authenticated-orcid":false,"given":"Ryan","family":"McNeil","sequence":"first","affiliation":[{"name":"Program in Addiction Medicine Yale School of Medicine  New Haven USA"},{"name":"General Internal Medicine Yale School of Medicine  New Haven USA"},{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4567-2885","authenticated-orcid":false,"given":"Nitsaha","family":"Puri","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade","family":"Boyd","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samara","family":"Mayer","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"},{"name":"Interdisciplinary Studies Graduate Program, University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-2928","authenticated-orcid":false,"given":"Kanna","family":"Hayashi","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Small","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, St. Paul's Hospital  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.06.010"},{"key":"e_1_2_7_3_1","first-page":"CD002209","article-title":"Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence","volume":"2","author":"Mattick RP","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.91.5.774"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.00153"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12682"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjc\/azh085"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000642"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.02905.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303627"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002208"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01232.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp186"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.09.004"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.05.014"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00130-2"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2013.05.005"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12411"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2009.00064.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-016-0100-7"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000090"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.04.008"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(15)00129-0"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.08.037"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199708000-00001"},{"key":"e_1_2_7_26_1","volume-title":"Qualitative inquiry and research design: choosing among five approaches","author":"Creswell JW","year":"2017"},{"key":"e_1_2_7_27_1","unstructured":"Centre for Addiction and Mental Health (CAMH).Opioid Dependence Treatment Core Course. Module 2: Treatment Options. Choosing between methadone and buprenorphine maintenance treatment2015."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2010.00086.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0027-9684(15)30175-9"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.10.020"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.09.006"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990903108215"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-8-17"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001294"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdar.13049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.13049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.13049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.13049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T15:12:22Z","timestamp":1694013142000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.13049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1111\/dar.13049"],"URL":"https:\/\/doi.org\/10.1111\/dar.13049","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]},"assertion":[{"value":"2018-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}