Stigma is a Moral & Social Justice Issue:
How Our Mobile MAT Van program aims to reduce the harm it inflicts on those living with substance use disorder
I wanted to circle back to something I have put great emphasis on in my previous posts,which is the importance of raising awareness surrounding the stigma associated with substance use and how it impacts those living with substance use disorder (SUD), more specifically, opioid use disorder (OUD). I do not like raising an issue, without also providing solutions. I will discuss why I view stigma as a human right’s issue, as evidenced by what I observe in the field. I will also provide ways in which we can all help reduce the stigma & shame people living with SUD face.
One Peer’s Perception
Through my professional & lived- experiences working, living, & recovering within the substance use community, I have attained this deeply -rooted belief that stigma is a moral & social justice issue, that is causing significant barriers to people accessing treatment services & supports for their use, increases people using alone, which dramatically increases the chance for overdose & death.
In my role as a Mobile Outreach Worker (MOW), I spend countless hours, having countless conversations, with countless individuals, debunking myths & misinformation surrounding OUD
& MOUD. It is my job to provide people with facts about opioid use disorder & the medications used to treat it. Facts that are backed by science & grounded in evidence.
Somehow I am still amazed each time I hear people say things like they don’t support MOUD treatment because they don’t view it as really being in “real recovery”, or it is “replacing one drug for another.” Neither of these are true. In fact, SAMHSA’s website states, “Medications used for MAT are evidence-based treatment options and do not just substitute one drug for another (SAMHSA).”
The Impact
The stigma people experience around their substance use can have devastating results, which may include the loss of hope for themselves & their recovery, how they are perceived, or even treated within our systems and institutions (hospitals, jails, treatment facilities, self-help groups, etc.).
SUD stigma can also have a great impact on the families of these individuals, fostering a lack of understanding & support for their loved one who is struggling, instead of creating space that feels safe enough for them to ask for help .
Stigma is so deeply ingrained in how society discusses , views, and treats those struggling with SUD. This concept proves true whether discussing people in remission/recovery from OUD, those on a MOUD as part of their treatment regimen, such as myself, or, most importantly, individuals who are in current active or chaotic use.
MAT Stigma
Individuals who are prescribed medications used to treat their opioid use disorder (MOUD), like Suboxone and Methadone, often face additional stigma and discrimination surrounding their use of these medications, it’s impact felt on multiple levels. According to an Online Medical Journal, titled “Human Rights, Stigma, and Substance Use,” “medication assisted treatment (MAT) is the current gold standard of care for treatment for opioid dependence, since its use is associated with reduced risk for relapse and mortality, yet stigma may present a barrier to its use, including stigma associated with MAT use within sectors of the treatment community, (Wogen & Restrepo, 2020).”
A Silent Killer
I will never forget a participant I lost a few years ago because of the stigma associated with/MAT. Part of a self help group, he wanted to write the 12 steps with his sponsor. His sponsor told him he would need to get off of methadone before he could start writing the steps with him. Heeding his mentor’s advice he got off the methadone and died less than 2 weeks later from an overdose. “Some peer led groups and 12 step recovery support programs may not support MAT use, and consequently individuals in recovery who are on MAT may experience stigma from peers or group facilitators or, perhaps unintentionally, be persuaded to discontinue MAT use”, according to Wogen & Restrepo, (2020).
What can be done?
In my opinion, the single best way to combat the stigma associated with SUD is utilizing Person-First Language when discussing substance use, treatment, & recovery. Words are extremely powerful and the words we use to discuss SUD or any other mental health condition, undoubtedly has an impact on society’s perceptions, attitudes and behaviors toward those living with SUD. “Language frames what the public thinks about substance use, treatment, and recovery, and it can affect how individuals think about themselves and their own ability to recover ”, according to NIH’s Online Medical Journal (Wogen & Restrepo, 2020).
We also must be willing to hold the people around us, whether our friends, family members or colleagues, accountable for the words they use to discuss SUD. Of course there will always be those who refuse to increase their knowledge or change their views, attitudes or behavior towards people with SUD, but I refuse to be one of them. I always try to remain teachable in everything I do or know.
I have included a few resources that provided examples of person-first language surrounding substance use.
References
https://www.samhsa.gov/medication-assisted-treatment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348456/
https://www.safeproject.us/resource/person-first-language/
If you or someone you know may benefit from any of the services offered on the Mobile MAT Van, please contact Jess @ 860-336-9412. We can also be found on Facebook, Instagram, our website, or by calling any of our three offices.