Stop the Stigma: Breaking the Stigma of Methadone Maintenance Treatment

Stop Stigma Now:BREAKING THE STIGMA OF

METHADONE TREATMENT

Breaking the Stigma of Methadone

Treatment

Chesie Roberts, MS, ALC, ADC

Northwest Alabama Treatment Center

Bessemer, Alabama

Supervised by Patrick A. Brindley, M. ED, LPC Brindley Group, LLC

Why am I here today?

“You have your way. I have my way. As for the right

way, the correct way, and the

only way, it does not exist.”

-Friedrich Nietzsche

Why are you here?

A. I don’t know anything about methadone

treatment?

B. I have had bad experiences with methadone

patients?

C. I know about methadone and want to learn how to

stop the stigma?

“Finding Normal”

Overview of Presentation

History of Methadone – Myths & Misconceptions

Defining Stigma – Types, Experiences, Impact

How to Reduce Stigma

History of

Methadone

Treatment

Post WWII Heroin

Epidemic

Decreasing dose vs.

Maintaining dose

Methadone Treatment Effectiveness

“ The scientific evidence and knowledge about methadone being an effective and proven method

is not the reason that more people don’t seek treatment it’s the stigma of the treatment….”

Myths and

Misconceptions

Opiate addiction is a

Behavioral problem

Myths and

Misconceptions

Methadone is

Addicting

Myths and

Misconceptions

Methadone is a legal

way to get high

“patients come to

treatment

looking for the

maximum dose

of methadone….”

Myths and

Misconceptions

Once your on

methadone you

can’t get off

“Anti-medication

culture”

Myths and

Misconceptions

Methadone is

Deadly

Myths and

Misconceptions

Methadone hurts your health

-Rots your bones

Myths and

Misconceptions

Methadone causes

drowsiness

Myths and

Misconceptions

Methadone is

dangerous for

pregnant

addicted women

Myths and

Misconceptions

Methadone Clinics

are not monitored

or closely regulated

Myths and

Misconceptions

Methadone is

Recovery

“Magic Bullet”

Stigma

Stigma is the experience of being “Deeply Discredited” due to one’s

“Undesired Differences”.

To be stigmatized is to be held in contempt, shunned, or rendered socially invisible

because of a socially disapproved status. This includes labeling, stereotyping, social

rejection and exclusion.

“Robbie” story

Stigma

Felt/Self Stigma – Personal Feelings of Shame

Enacted Stigma – Direct Experience of Unfair Treatment by Others

“Elvis” story

Stigma

Perceived Stigma – The perception of being Stigmatized

The Stigma varies depending on the level of stigma a patient experiences

Courtesy Stigma – Stigma experienced by family members of patients

“Christine’s” story

“Wendy’s” story

Stigma

Personal strategies to deal with Stigma

Secrecy/Concealment – “Kevin/Tricia”

Social Withdrawal – disconnected, inability to be authentic

Stigma

Personal strategies to deal with Stigma

Selective Disclosure

Preventative Disclosure

Strategic Interpretation

Stigma and Recovery

Medication Acceptance – Addiction and hedonism

“Melissa’s” story

Perception of Addiction – patient? sinner? criminal?

Stigma and Recovery

Stigma Related to Choice of Treatment

AA vs. MMT

Natural Recovery vs. Professional Recovery Inpatient vs. Outpatient

Stigma and Recovery

Stigma related to the intensity of the problem – Alcohol, Tobacco, THC

Cocaine, Crack, Meth, Heroin

Good drug vs. Bad drug

Stigma and Recovery

Stigma related to choice of treatment

Natural Recovery vs. Professional Recovery

AA/NA vs. MMT

Alcohol vs. Heroin

Inpatient vs. Outpatient

Medication vs. Non-medication

“Terry”

Types of Stigma

You tube video NBC News Methadone clip

Types of Stigma Words – Language –

Visual Images

Addict vs. Person in addict addiction

Abuse vs. Misuse

Clean/Dirty vs. Negative/Positive

Habit vs. Active addiction

Replacement/Substitution vs. Treatment

User vs. Misuse

Types of Stigma

“Words are important. If you want to care for something you call it a flower, if you

want to kill something you call it a weed.” – Don Coyhis

Impact of Stigma

Denial of Employment impacts the greatest number of patients

Childcare providers, Nurses, Commercial drivers

Impact of Stigma

Lack of insurance coverage – Greatest impact on those in treatment

Barriers to treatment due to income

Not universally covered by Medicaid

Average cost to patient is $5k/year

Impact of Stigma

Discrimination by professionals in critical roles of responsibility

Judges, Social Workers, Doctors, Law Enforcement

Impact of Stigma

“Nicole’s Story”

Impact of Stigma

Stigma by the State and Federal Government

No Methadone Clinics in Mississippi

Stigma – Stigma within the community

Social Stigma

Shame

High Dose

Daily Dose

Loss of Control

Dose and Go

How to Reduce

Stigma

Problems with Social Reform

Campaigns

How to Reduce Stigma

Train and Inform Patients

“Certified Methadone Advocate

Training”

Patient lead Recovery

Groups/Mentors

How to Reduce Stigma

Faces and Voices of Recovery Organization

Trailer of “The Anonymous People”

Positive Images of persons in Treatment

How to Reduce

Stigma

National Education Initiatives

How to Reduce

Stigma

Professional Education

How to Reduce Stigma

Change the Language

Betty Ford

How to Reduce Stigma

Change Treatment Center

Practices

One Size Doesn’t Fit All

.

I'VE MISSED MORE THAN 9000 SHOTS IN MY

CAREER. I'VE LOST ALMOST 300 GAMES. 26 TIMES,

I'VE BEEN TRUSTED TO TAKE THE GAME WINNING

SHOT AND MISSED. I'VE FAILED OVER AND OVER

AND OVER AGAIN IN MY LIFE. AND THAT IS WHY I

SUCCEED.

MICHAEL JORDAN