Table 15 Analytical themes resulting from qualitative synthesis

Theme #1: Feeling trusted to self-manage treatment

Clients felt trusted when they were provided with take-home doses. Take-home doses reassured them that they were doing well in treatment and increased pride, responsibility, and treatment autonomy.

Theme #2: Navigating environmental risks

Take-home doses allowed clients to reduce their exposure to triggers of illicit substance use and stigma. Reduced anxiety created space for experiences and environments that promoted client well-being.

Theme #3: Life/treatment balance

Take-home doses eliminated daily conflicts between treatment obligations and employment. With treatment consuming less of their time and energy, clients gave their attention to family and other rewarding activities.

Theme #4: Emotional and psychological impact of not receiving take-home doses

Clients who did not receive take-home doses during COVID-19 felt punished and exposed to unnecessary risk. Housing stability was a barrier to equitable treatment.