Overcoming the Stigma of Medication For Opioid Use Disorder

Medication for opioid use disorder (MOUD) is the gold standard for treating opioid use disorder. However, only 11% of people diagnosed with OUD get a prescription for these medications.¹ MOUD faces heavy stigma across the paradigm of treatment and recovery and even amongst people who are on or have utilized MOUD at some point in their life.

Internalized stigma

I was first introduced to MOUD in 2011 by some friends. Although I didn't have a prescription, I would get it from the street and use it when I couldn’t score my drug of choice. If we flash forward a few years later, I found myself seeking treatment with MOUD around 2013 after a bad car accident.

It was the first time since I started using that I had sought out help. I kept it a secret from my family because I knew they would look down on me, and I felt a lot of guilt and shame for my return to use.

Looking back now, I realize that I had my own internalized stigma, and I mentally beat myself up for being on medication for opioid use disorder and not being good enough to just quit. I felt shame for it and didn’t consider myself to be “clean,” which is now irrelevant. I didn’t see myself as being on the same page as others in recovery that took the 12-Step or non-MOUD route. This made catching traction in my recovery process incredibly difficult due to how my peers made me feel about my process. I only knew what I was taught.

My family didn't support my recovery

Some of my family members eventually found out that I was on MOUD. Instead of supporting me, they routinely told me I was using it as a crutch because I wasn’t ready to be off drugs. This wasn’t the case at all.

During my first detox, I came off multiple substances cold turkey. It was horrible, and I didn't want to go through that horror again. Mind you, my parents didn’t know I was coming off benzodiazepines too. I could’ve suffered some bad consequences from detoxing cold turkey.

I couldn't afford treatment

Unfortunately, after about a year and a half on the medication, I was robbed by my close friends. Because of this, I could no longer afford to pay for treatment since I was paying out of pocket.

I eventually caved and asked my father if I could use his insurance to help cover my treatment. He declined and said he would only help me if I went to detox and residential.

I'm sure some people would question how this is a bad thing. While I’m grateful he did that, I’m very fortunate that it worked out for me the way it did. I detoxed successfully despite my insurance halting payments for detox, and I had to go to sober living early.

Any positive change is recovery

I’ve seen folks get shamed in meetings and told they’re "less than" because they’re on MOUD. Those people will attempt to come off MOUD, return to use, and die. I’ve seen this happen several times. These deaths were preventable, as all deaths from substance use are.

I would hope that everyone asks themselves what recovery looks like for them. For me, any positive change is recovery, and I think abstinence is a poor way to measure success in recovery. I’ve seen people on MOUD be as successful, if not more successful, than those who are not on MOUD.

Every pathway can be successful, and we must honor everyone’s autonomy. Their life depends on it.

Did you ever experience stigma for being on medication for opioid use disorder or wanting to start MOUD?