Reproduced with kind permission. This article originally appeared in the NADA Advocate eMagazine, published in December 2021. Readers can subscribe to the Advocate here.
There is ample research to support the efficacy of opioid treatment (e.g., methadone, buprenorphine) to reduce opioid use, decrease mortality, and improve health and quality of life,[1] but unlike other effective medical interventions, it is widely misunderstood, distrusted, and ultimately stigmatized. I recall when working in the child protection system, when it was mentioned that a parent was on opioid treatment, this became the focus of their assessment. But to be fair, it's not only child protection workers that misunderstand, but also health professionals including doctors and nurses, and other workers across the wider service sector.
To learn how we can help to reduce the stigma around this treatment, I spoke with Kevin about his experiences being a consumer on this program, and Carolyn Stubley (Nursing Manager, WHOs) and Lyn Roberts (Manager, WHOs).
How does stigma impact people accessing opioid treatment?
Inadequate pain relief stories are rife. Lyn and Carolyn recounted one WHOs resident who was taken to the emergency department for a total of five times. On the first four visits he was discharged because he was reported to be 'drug seeking'. On the fifth occasion, a WHOs manager accompanied the resident and refused to leave until a proper assessment and diagnosis was made. Following this, the resident was admitted to hospital for five days with post virus rheumatoid arthritis.
Kevin felt he was often treated differently because he was on this treatment, especially when accessing his dose at some chemists. It can negatively impact people's mental health and self-esteem, he said.
'Many consumers engaged in WHOs Opioid Substitution Therapy (OST) program report limited social or economic opportunities—mostly due to the stigma,' said Lyn.
Why is opioid treatment and people on this program stigmatised?
Kevin cites criminalisation of heroin, and intravenous drug use to be contributing factors. Carolyn and Lyn added that the same negative labelling was attached to people who sought opioid treatment. 'OST is an evidence based treatment that facilitates change in a person's life, yet this has not been widely accepted in the wider community.'
How can the AOD sector help to reduce the stigma related to opioid treatment?
All interviewed believed that education and training was critical for reducing this stigma. 'There is a lot of misinformation attached to OST and educating the public and health systems to the effectiveness of OST as a treatment is essential in reducing stigma and discrimination,' Lyn and Carolyn declared.
Kevin suggested, 'People should take a tour of the MSIC (Medically Supervised Injecting Centre) to become more informed.' Kevin has already led a range of people, from politicians to business owners to tour MSIC, which is a promising strategy.
Lyn and Carolyn recommended that the sector take a trauma informed approach to educating the community and health services about people on this treatment. 'Many people on OST have suffered trauma in one way or another and the public don't hear the stories of these survivors, what they have endured and what has improved since being on treatment.'
Resources
For more information about the NSW opioid treatment program, visit the NSW Health website.
[1] NSW Health Guidelines for the Treatment of Opioid Dependence
