Citation

Richard EL, Schalkoff CA, Piscalko HM, Brook DL, Sibley AL, Lancaster KE, Miller WC, Go VF. Int. J. Drug Policy 2020; ePub(ePub): 102704.

Affiliation

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.drugpo.2020.102704

PMID

32173274

Abstract

BACKGROUND: Medication-assisted treatment (MAT) is an evidence-based strategy to treat opioid use disorder (OUD). However, MAT-related stigma reduces MAT uptake, which is particularly low in rural areas. To date, perceptions and attitudes towards MAT in rural settings have not been described.

OBJECTIVE: This qualitative study aims to characterize perceptions and attitudes towards MAT and the environmental factors contributing to these views in Appalachian Ohio.

METHODS: From February to July 2018, semi-structured interviews were conducted with 34 stakeholders (12 healthcare professionals, 12 substance use treatment providers, 7 law enforcement agents and judicial officials, and 3 members of relevant organizations) in three rural counties in Appalachian Ohio. Interviews were transcribed, coded, and analyzed to characterize the risk environment and participants' perceptions and attitudes towards MAT.

RESULTS: Participants expressed or described pervasive MAT-related stigma in the region. Participants consistently described three elements of the environment affecting stigma: (1) a "conservative" culture in which abstinence is necessary to be in recovery successfully, (2) fear of medication diversion and abuse, and (3) drug court policies that keep MAT out of the criminal justice system.

CONCLUSION: MAT-related stigma will need to be addressed to tackle the opioid epidemic through evidence-based treatment effectively.

Copyright © 2020 Elsevier B.V. All rights reserved.

Language: en

Keywords

Appalachia; Medication-assisted treatment; Opioid use disorder; Risk environment; Rural; Stigma