Emma L Richard1, Christine A Schalkoff2, Hannah M Piscalko3, Daniel L Brook3, Adams L Sibley2, Kathryn E Lancaster3, William C Miller3, Vivian F Go2. 1. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA. Electronic address: emrichar@montefiore.org. 2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 3. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
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.
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.
Authors: Christopher M Jones; Melinda Campopiano; Grant Baldwin; Elinore McCance-Katz Journal: Am J Public Health Date: 2015-06-11 Impact factor: 9.308
Authors: Lewei Allison Lin; Michelle R Lofwall; Sharon L Walsh; Adam J Gordon; Hannah K Knudsen Journal: Drug Alcohol Depend Date: 2018-03-10 Impact factor: 4.492
Authors: Bradley D Stein; Adam J Gordon; Mark Sorbero; Andrew W Dick; James Schuster; Carrie Farmer Journal: Drug Alcohol Depend Date: 2011-11-16 Impact factor: 4.492
Authors: Robert P Schwartz; Jan Gryczynski; Kevin E O'Grady; Joshua M Sharfstein; Gregory Warren; Yngvild Olsen; Shannon G Mitchell; Jerome H Jaffe Journal: Am J Public Health Date: 2013-03-14 Impact factor: 9.308
Authors: Zev Schuman-Olivier; Hilary Connery; Margaret L Griffin; Steve A Wyatt; Alan A Wartenberg; Jacob Borodovsky; John A Renner; Roger D Weiss Journal: Am J Addict Date: 2013-04-11
Authors: Ekaterina Pivovarova; Elizabeth A Evans; Thomas J Stopka; Claudia Santelices; Warren J Ferguson; Peter D Friedmann Journal: Drug Alcohol Depend Date: 2022-03-07 Impact factor: 4.852
Authors: Tarlise Townsend; David Kline; Ariadne Rivera-Aguirre; Amanda M Bunting; Pia M Mauro; Brandon D L Marshall; Silvia S Martins; Magdalena Cerdá Journal: Am J Epidemiol Date: 2022-03-24 Impact factor: 5.363
Authors: Katherine Mackey; Stephanie Veazie; Johanna Anderson; Donald Bourne; Kim Peterson Journal: J Gen Intern Med Date: 2020-11-03 Impact factor: 5.128
Authors: Gemma Reynolds; Brittany L Lindsay; Stephanie Knaak; Andrew C H Szeto Journal: Int J Ment Health Addict Date: 2022-01-20 Impact factor: 11.555
Authors: Daniel L Brook; Angela T Hetrick; Shibani R Chettri; Christine A Schalkoff; Adams L Sibley; Kathryn E Lancaster; Vivian F Go; William C Miller; David M Kline Journal: Open Forum Infect Dis Date: 2021-05-17 Impact factor: 3.835
Authors: Umedjon Ibragimov; Katherine E Cooper; Evan Batty; April M Ballard; Monica Fadanelli; Skylar B Gross; Emma M Klein; Scott Lockard; April M Young; Hannah L F Cooper Journal: Harm Reduct J Date: 2021-06-30