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The Stigma Around Methadone Maintenance is Dangerous

Through my early career in addictions, I avoided recommending methadone maintenance treatment because I was caught up in the stigma around it.

My name is Adam and I am not a sober mom. I have, however, been working in the addiction field for more than a decade. Throughout these years I have worked in numerous types of treatment facilities. I have worked in residential detox programs, women’s shelters, teen programs, etc.

Since 2010, I have been working in the most discriminating and stigmatizing treatment around—methadone maintenance treatment.

For ten years of working in the field, I heard negative comments about methadone treatment. I was the worker who would not make referrals for this type of methadone maintenance treatment because of it.  I thought there was little recovery that happened at methadone clinics because I never heard about any. I never heard anyone advocating for the treatment so I figured it must be bad. In 2010 I decided to put aside the ten years of negativity and see for myself what this treatment is all about.

The first thing I noticed was the number of pregnant women at the methadone clinic. My first initial reaction was, “THAT.POOR.BABY.” After doing some research,  I found out that the National Institute for Drug Addiction (NIDA) suggests, a stable dose of methadone is actually safer for a fetus than one-time heroin use during pregnancy.

I started to actually learn about methadone with an open mind. After meeting with pregnant clients in the treatment, I learned about some of the real dangers associated with the surrounding stigma.

Every single one of my clients experienced negativity and judgment at their OBGYN appointments.

At the hospital while giving birth, women reported hearing comments made like, “Why don’t you just get off the methadone?”  In the middle of a pregnancy, unless promoting miscarriage, why would a medical professional recommend this sort of action? This is supposed to be one of the most wonderful days of their lives and instead of hearing, “Congratulations!” they’re receiving judgmental comments and looks from medical professionals!

A woman I know had a c-section and during the procedure the doctor cut the side of the baby’s face. When he was explaining what happened, he stated she was lucky he hadn’t cut the baby’s throat. Can you imagine? Would he have said this if the patient were not on methadone?

Another concerning comment, “Your baby is going to go through severe withdrawal.”  This concerns me because in my experience, every baby is different. I have seen some babies go home with mom, and I have seen some stay for three months. There is no way of predicting. I understand giving the women information, but not as a matter of fact, rather than a possibility.

Most of the negativity around methadone actually begins with treatment providers, then trickles down to the client experiences. Hearing our negative connotations when we offer methadone as an option. It’s no doubt that moms who are on methadone are put through the ringer during pregnancy and after.

Do our medical professionals know that the Department of Public Health for Massachusetts recommends methadone maintenance to moms who are pregnant? Even when they are six months sober, because of the high rate of relapse?

Our medical professionals go against state recommendations because they’ve stigmatized methadone treatment to moms. The result is judgment against the moms and poor recommendations from the professionals.

Methadone is the most regulated controlled substance in the state of Massachusetts. It is dispensed by medical professionals every day. Methadone is one of the more structured outpatient substance abuse programs around. People are unaware of the successes of this treatment because clients who are doing well do not always share because of the stigma surrounding it. People who are struggling on the clinic are obvious because they appear high. Everyone notices people who are high, but try to notice sober moms who are on the clinic. You can’t always because they look like others who are people who have not had addiction struggles. Therefore, we do not know about success stories in this treatment modality because of stigma, bottom line.

Today I am confident when I say that methadone has helped many people regain their humanness, rebuild their lives, and make the safe transition off of the treatment.

A few things in review:

  1. Few clients/moms feel comfortable sharing they are enrolled in methadone treatment.
  2. Lots of medical /addiction professionals are uneducated around methadone treatment. (I was)
  3. Massachusetts recommends moms who are pregnant to be enrolled in methadone treatment, even if sober for few months.
  4. Many clients first experience in treatment is met with a negative talk about methadone treatment which leads to ongoing false perception of the treatment
  5. All women have the right to be treated with respect and have their delivery day be a special one.

There are a lot of myths that haven’t been touched on in this and will be glad to in the near future. Just know that there is a lot more to it medically and clinically.

If you have questions, please leave them in the comments and I will happy to answer them or direct you to someone who can.

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  1. Thanks for writing this helpful piece on methadone and pregnancy. There is so much ignorance and misinformation out there regarding methadone treatment and pregnancy. You should write another post on the risks associated with getting pregnant and stopping drug use instead of getting on methadone. I know pregnant women feel pressured to just stop using when they find out they are pregnant when really the safest thing to do is start treatment. Thanks again for the information!

  2. Thank you. I do agree with methadone or suboxone treatment. However it seems like a majority of the people i know on the clinic are stuck there unable to get off. I will admit i am nieve when it comes to this as i am an alcoholic and as of yet have not had to use heroine but addiction is addiction. I know more than 1 person who has been on the clinic for well over 10 years. Why aren’t the clinics weaning patients off of methadone or suboxone? I had to take naltrexone for support and then had to come off if it. As far as pregnancy is concerned i do agree with treatment to alleviate relapse and help the babies but 10 years? Come on now!! Life is life. Get support. Get treatnent. Move on and live

  3. Erin- excellent question, very commonly asked. A lot of times when people get on methadone treatment they are looking for the quick fix. We all know people who have struggled and have stayed stuck in their recovery , and those are the people you are speaking about. They have become complacent with their recovery, stopped setting goals. they are so stuck and complacent that it is not safe to be discharged from treatment either. Its really up to the clinician and the client to stay engaged with recovery goals.
    A good methadone plan could look like this:

    years 1 and 2- Focus on practicing not using illicit substances
    years 3 and 4- Focus on building up your supports /recovery
    year 5- taper off the clinic- decreasing dose 1-2 mgs bi weekly(Only way I have seen success in a taper).

    obviously this is an example , but a good idea on what this type of treatment should look like. Clinics have plenty of people to treat , so not a matter of keeping poeple in treament to make money or anything like that. Where there are 10 clients who discharge, there are another 10 waiting to enroll.
    Please let me know if this answers your question and feel free to ask more questions about this form of treatment.

  4. I am a strong supporter of methadone maintenance treatment. As I have been in recovery for some years and I have had two babies on methadone. Sadly, my first child was born in addiction and I never had custody. I am tapering slowly 2 mgs and when I’m low enough it will switch to 1 mg. I’ve had great success in my motherhood, recovery, life, relationships, etc. I am very pleased that someone in the medical field took the time to properly educate themselves. The negative stigma surrounding MMT is uncalled for. As you said giving birth should be one of the best days of your life. You should not be made to feel like scum! Adam-Thank You

  5. Thank you for being open minded and truthful in your post. I am a sober mom and I have methadone to thank. My entire life was one addiction after another. When I hit my 20’s crystal meth was my thing, after getting clean for a few years I needed major back surgery and became addicted to opiates. I gave birth to my son six years ago and by the grace of GOD did not use during my pregnancy, however after losing my father to cancer I relapsed. Within three weeks I was in detox and decided to try methadone. It saved my life. Every day I hear of someone overdosing and dying, and I only wish more people were open about their success with it so that more people would try it and possibly live a little longer.

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