Stigma is a Major Impediment to Treating the Opioid Crisis

German Lopez, a writer at VOX, has spent much of 2017 producing great work on opioids in North America. He demonstrates a level of clarity in his writing that is often missing from the discussion around the opioid crisis. The tendency of journalism to try to present "both sides" often leads to muddled writing and difficulty discerning whether there are better and worse ways to help people with their addiction.

The evidence is overwhelming that Medication Assisted Treatment (MAT)works. Not only does it work, but it is far more effective than abstinence based programs. Why is it so hard for American society to come to grips with this? Lopez says a huge obstacle is the stigma associated with addiction, the sense that addicts are somehow morally weak. If someone is weak, then all that is needed is counseling to help them get strong. Unfortunately, for many, that implies that the use of medication to help addicts recover is somehow viewed as a crutch, as substituting one addiction for another.

His latest article is worth a read, but we wanted to give some personal experiences of 2017 to illustrate how stigma reared it's ugly head and slowed many of our attempts to grow:

  • Facebook—We spent a lot of time in the beginning of the year trying to figure out how to effectively advertise on Facebook. It was difficult generally, but what made us give up eventually was the relentless trolling we faced. Many times each day we would have to rebut ugly comments about Medication Assisted Treatment and/or worse, the condemnation of our patients.
  • Zoning as a weapon:
    • Elkton—The town and Cecil County sued MATClinics in September and prevented us from opening a small office. The County Executive described MAT as a legalized form of drug dealing. The City Council was so afraid of us treating it's constituents that it imposed a six month ban on ANY new medical practice (dentists, internists, radiology centers, etc.). Cecil County has one of the highest opioid mortality rates in the country.
    • Glen Burnie—Anne Arundel County made a determination that MATClinics was a State Certified Medical Clinic, despite the obvious fact that we are not. Once they categorized us that way, there is no location in the County for us to open an office. As one zoning official told us, the County reverse engineered the requirements for Certified Medical Clinics to ensure that not a single parcel would qualify for zoning approval. We have dozens of patients that drive more than an hour to our existing offices from Anne Arundel County to see our providers. We even have many patients driving hours from the eastern shore, through Anne Arundel County to get to our providers. The need is real, our treatment works and looks just like any other doctors office, but that does not stop politicians and their bureaucrats from allowing the stigma associated with MAT from blocking our doctors efforts to treat.
  • Landlords—In areas where zoning is not a problem, we have great difficulty finding landlords who will allow us to open in their properties. The real estate agents that represent the landlords act as a convenient foil. It is an interesting question whether landlords can discriminate in this way, but we are way too small to challenge them and they know it.

2017 was a great year for MATClinics. We are treating hundreds of patients and employ more than a half dozen committed providers. We will persevere and continue our trajectory of growth, but it has been discouraging and surprising to see the level of both organic and organized opposition to our efforts, much of it driven by the stigma that German Lopez highlights in his work at VOX.