 We know that opioid maintenance treatment holds many benefits for opioid-dependent patients. But we also know that these positive treatment effects are highly influenced by the way we deliver treatment. In the field study we conducted, our aim was to identify areas of improvement across Europe in current opioid maintenance treatment approaches. And for that purpose we asked patients who were currently in the treatment system for their reasons for entering treatment, for treatment rules and also for things that would make it easier for them to stay in treatment. On the other hand we also asked active opioid users who were currently not in treatment for their reasons for staying out of treatment. Our results clearly highlighted that patients are motivated to work towards recovery. The active opioid users on the other hand reported considerable concerns about their own ability to adhere to the treatment rules and also to make it through treatment. When we looked at the rules and regulations pertaining to opioid maintenance treatment we saw large differences between the European countries. So that tells us it is very important to attain a balance between an over-regulation on the one hand and less a fair attitude on the other hand. If we would make treatment settings more flexible and thus allow to tailor the treatment plans to the actual patient needs, we might be able to encourage those who are worried about their own ability to make it through treatment, to enter treatment and second we may also be able to increase the treatment retention rates. But of course it is also very important to have a certain treatment structure in order to support the patient in resolving their chaotic lifestyle.