This is a presentation that I give every year at the Alabama School of Alcohol and Drug Conference. I am working to break the stigma related with patients choice of methadone treatment.

1. Stop Stigma Now:
BREAKING THE STIGMA OF
METHADONE TREATMENT

2. 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

3. 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

4. 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?

5. “Finding Normal”

6. Overview of Presentation
 History of Methadone – Myths & Misconceptions
 Defining Stigma – Types, Experiences, Impact
 How to Reduce Stigma

7. History of
Methadone
Treatment
Post WWII Heroin
Epidemic
Decreasing dose vs.
Maintaining dose

8. 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….”

9. Myths and
Misconceptions
Opiate addiction is a
Behavioral problem

10. Myths and
Misconceptions
Methadone is
Addicting

11. Myths and
Misconceptions
Methadone is a legal
way to get high
“patients come to
treatment
looking for the
maximum dose
of methadone….”

12. Myths and
Misconceptions
Once your on
methadone you
can’t get off
“Anti-medication
culture”

13. Myths and
Misconceptions
Methadone is
Deadly

14. Myths and
Misconceptions
Methadone hurts your health
-Rots your bones

15. Myths and
Misconceptions
Methadone causes
drowsiness

16. Myths and
Misconceptions
Methadone is
dangerous for
pregnant
addicted women

17. Myths and
Misconceptions
Methadone Clinics
are not monitored
or closely regulated

18. Myths and
Misconceptions
Methadone is
Recovery
“Magic Bullet”

19. 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

20. Stigma
Felt/Self Stigma – Personal Feelings of Shame
Enacted Stigma – Direct Experience of Unfair Treatment by Others
“Elvis” story

21. 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

22. Stigma
Personal strategies to deal with Stigma
 Secrecy/Concealment – “Kevin/Tricia”
 Social Withdrawal – disconnected, inability to be authentic

23. Stigma
Personal strategies to deal with Stigma
 Selective Disclosure
 Preventative Disclosure
 Strategic Interpretation

24. Stigma and Recovery
 Medication Acceptance – Addiction and hedonism
 “Melissa’s” story
 Perception of Addiction – patient? sinner? criminal?

25. Stigma and Recovery
 Stigma Related to Choice of Treatment
 AA vs. MMT
 Natural Recovery vs. Professional Recovery
 Inpatient vs. Outpatient

26. Stigma and Recovery
 Stigma related to the intensity of the problem – Alcohol, Tobacco, THC
Cocaine, Crack, Meth, Heroin
 Good drug vs. Bad drug

27. 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”

28. Types of Stigma
You tube video NBC News Methadone clip

29. 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

30. 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

31. Impact of Stigma
Denial of Employment impacts the greatest number of patients
 Childcare providers, Nurses, Commercial drivers

32. 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

33. Impact of Stigma
Discrimination by professionals in critical roles of responsibility
 Judges, Social Workers, Doctors, Law Enforcement

34. Impact of Stigma
“Nicole’s Story”

35. Impact of Stigma
Stigma by the State and Federal Government
 No Methadone Clinics in Mississippi

36. Stigma – Stigma within the community
Social Stigma
Shame
High Dose
Daily Dose
Loss of Control
Dose and Go

37. How to Reduce
Stigma
Problems with Social Reform
Campaigns

38. How to Reduce Stigma
 Train and Inform Patients
 “Certified Methadone Advocate
Training”
 Patient lead Recovery
Groups/Mentors

39. How to Reduce Stigma
Faces and Voices of Recovery Organization
 Trailer of “The Anonymous People”
 Positive Images of persons in Treatment

40. How to Reduce
Stigma
National Education Initiatives

41. How to Reduce
Stigma
Professional Education

42. How to Reduce Stigma
Change the Language
Betty Ford

43. How to Reduce Stigma
Change Treatment Center
Practices
One Size Doesn’t Fit All

44. .
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