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Over the past ten years, there has been a consistent increase in opioid use, which has resulted in an increase in enrolment in methadone maintenance therapy [MMT]. With retention in MMT being a key factor, in order to understand the process of retention, it is important to gain an understanding of individual perceptions and experiences. No research in Ottawa, Ontario has addressed the perspective of MMT from people enrolled in MMT; therefore, nursing based research was undertaken. The objective was to understand the process and experiences associated with MMT from the perspective of persons who are enrolled in treatment. Twelve participants were engaged in semi-structured interviews. These participants described that, although MMT can positively affect the people who use such a treatment option, it continues to have a negative impact that repeatedly affects MMT initiation and delivery. The theoretical framework of Hardt and Negri’s “Triple Imperative of Empire” was used to analyze the research participants’ interviews within the current MMT program, to help develop a more inclusive healthcare service that addressed the current barriers hindering access and retention in treatment. The integration of this framework can help engage persons in treatment, tailor treatment to patient specific needs, and as a result increase access and retention in MMT programs.