Stigma Associated with Medications for Addiction Treatment: Negative Comments from Substance Use Treatment and Healthcare Providers

Background/Purpose: Medications for Addiction Treatment (MAT) have shown to be effective at improving treatment retention and reducing substance use, infectious disease, and mortality for those with opioid use disorders (Connery, 2015). However, access to MAT is limited, and roughly one-third of individuals with an opioid use disorder (OUD) enter into treatment—due in part to the stigma associated with MAT (Gyarmathy et al., 2008). The present study focuses on the experiences of adults receiving medication treatment and examines the stigma surrounding MAT. We examined rates and correlates of hearing negative comments about MAT from (1) substance use treatment and (2) healthcare providers.

Methods: Patients receiving methadone treatment at an opioid specialty clinic serving clients in a small urban community and surrounding rural areas (N = 267) were recruited to complete a computer-based survey (December 2019). Surveys assessed whether patients heard negative comments about MAT from healthcare providers and treatment providers (e.g., counselors, treatment staff). Surveys also included demographics (age, gender, race, education), substance use and related consequences, depression and anxiety symptoms, and experiences of shame. Logistic regression was calculated to assess predictors of greater odds of hearing negative comments about MAT from (1) substance use treatment and (2) healthcare providers.

Results: 27.9% of patients reported hearing negative comments about MAT from treatment providers and 56.7% reported hearing negative comments from healthcare providers. Individuals who reported more negative opioid use consequences (OR=1.09, p=.019) had greater odds of hearing negative comments from treatment providers. Younger patients (OR=0.97, p=.017) and those who reported greater shame due to MAT use (OR=1.42, p=.030) had greater odds of hearing negative comments from healthcare providers. Other variables were unrelated to either outcome.

Conclusions/Implications: Many adults receiving medication treatment reported hearing negative comments about MAT from treatment providers, particularly healthcare providers. These results highlight how stigma associated with MAT is common and can impact the recovery efforts of people in treatment. Substance use treatment providers and healthcare providers play an essential role in supporting individuals in treatment and recovery. Education about medication treatments may be warranted to help treatment and healthcare providers better understand the value of medication treatment and promote more positive views of these treatments. This study adds to previous research by highlighting individual factors associated with stigmatized views toward MAT that treatment and healthcare providers may hold. Greater consequences resulting from opioid use and internalized feelings of shame were associated with greater odds of hearing negative comments about MAT from substance use treatment and healthcare providers. Hearing more negative comments from healthcare providers may increase internalized shame. Bringing awareness to stigma helps to prevent it and thus can increase MAT entry and retention.

Connery, H. S. (2015). Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harvard review of psychiatry, 23(2), 63-75.

Gyarmathy, V. A., & Latkin, C. A. (2008). Individual and social factors associated with participation in treatment programs for drug users. Substance Use & Misuse, 43, 1865–1881.