Table 2 Summary of participants’ goals

Goal type

Substance use goals:

Many participants wanted to be ‘drug free’ or ‘abstinent’ but did not clearly define these terms. Several were uncertain about whether they would continue to use non-opioid drugs.

Long-acting injectable buprenorphine (LAIB) treatment goals:

Most participants wanted to reduce their LAIB and come off ‘at some point’ in the future. However, they often felt that there was no rush. Only two participants wanted to come off LAIB quickly. Some did not want to think about the future of their LAIB treatment.

Life goals:

Almost all participants wanted to achieve life goals relating to relationships, education, employment, housing, health, travel, hobbies, new routines etc. Few explicitly used the term ‘recovery’.

Goals over time

Goal consistency:

Participants generally reported consistent substance use, treatment, and broader life goals over time.

Evolving treatment goals:

Participants’ treatment goals sometimes evolved over time, moving from modest initial goals to more firm and ambitious treatment reduction plans at later interviews. Several participants, conversely, extended the time they wanted to remain on LAIB as the study progressed.

Disrupted treatment goals:

At their last completed interview, a small number of participants had stopped receiving LAIB (so disrupting their treatment goals). One participant had discontinued LAIB as she had not felt comfortable on the medication and three had been removed from LAIB by their service providers for not adhering to treatment protocols.

Goal mediators and moderators

Barriers to achieving goals:

Barriers to making progress towards treatment goals included personal poor health, lack of support from treatment services, and situational factors (e.g., homelessness and unstable housing, insufficient informal support, difficulty avoiding others who used drugs, lack of daily routines and meaningful activity, the closure of services because of COVID-19, and feeling uncertain about the future).

Enablers to achieving goals:

Factors that helped participants progress towards their goals included having supportive partners and family members, interests or activities that provided routine and structure, access to mutual aid meetings, and paid employment.