Shouting through bullet-proof glass: some reflections on pharmacotherapy provision in one Australian clinic.

The Opioid Substitution Treatment Program in New South Wales and Australia has a serious impact on the day to day lives of many people. The program and those consumers who rely upon it are seen with ambivalence by many in the wider community, and many consumers are discriminated against. It seems, to those of us who are engaged in it, that the system itself is confusing and sometimes arbitrary, and that a range of priorities other than clinical need dominate our experience of treatment. These pressures can manifest for us consumers as a punitive and unresponsive treatment experience that, rather than assisting us to live our lives, actually places barriers in our way and ties us up in knots that will take a long time to unravel.