Overcoming Medication Stigma in Peer Recovery: A New Paradigm

Krawczyk, Noa; Negron, Tianna M.; Nieto, Maia; Agus, Deborah; Fingerhood, Michael

doi:10.1080/08897077.2018.1439798

Cited by 48 publications

(27 citation statements)

References 27 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Support groups, for instance, could be a venue not only to engender social support among PWUDs but also a forum for participants to build intragroup solidarity and confront the erroneous labels perpetuated in mainstream discourse. Importantly, there are few such opportunities for PWUDs who are not in active recovery; 12-step programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) typically require a desire for abstinence, and even participants on MOUD report stigma in these settings (Krawczyk et al, 2018). Syringe service programs and other harm reduction sites may represent safer venues to formally or informally engage PWUDs in group-based social support without the perceived pressure of treatment seeking.…”

Section: Discussionmentioning

confidence: 99%

“I Was Raised in Addiction”: Constructions of the Self and the Other in Discourses of Addiction and Recovery

et al. 2020

View full text Add to dashboard Cite

The aim of this article is to address how conceptualizations of addiction shape the lived experiences of people who use drugs (PWUDs) during the current opioid epidemic. Using a discourse analytic approach, we examine interview transcripts from 27 PWUDs in rural Appalachian Ohio. We investigate the ways in which participants talk about their substance use, what these linguistic choices reveal about their conceptions of self and other PWUDs, and how participants’ discursive caches might be constrained by or defined within broader social discourses. We highlight three subject positions enacted by participants during the interviews: addict as victim of circumstance, addict as good Samaritan, and addict as motivated for change. We argue participants leverage these positions to contrast themselves with a reified addict-other whose identity carries socially ascribed characteristics of being blameworthy, immoral, callous, and complicit. We implicate these processes in the perpetuation of intragroup stigma and discuss implications for intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

“I Was Raised in Addiction”: Constructions of the Self and the Other in Discourses of Addiction and Recovery

et al. 2020

View full text Add to dashboard Cite

show abstract

“…This barrier has been observed in other studies, and often serves as a persistent deterrent to long-term OAT maintenance (Monico et al, 2015; Cooper & Nielsen, 2017). In an effort to combat this, it has been suggested that there is a need for recovery groups that recognize individuals on medication as being in recovery and destigmatize medication use to treat OUD (Krawczyk et al, 2018). …”

Section: Discussionmentioning

confidence: 99%

“…In addition, OATs have been underutilized in specialty substance use programs (Krawczyk, Feder, Fingerhood, & Saloner, 2017). Other barriers include MAT stigma, long waiting lists, treatment costs, non patient-centered treatment designs, lack of access through primary care, and zero tolerance approaches (Krawczyk, Negron, Nieto, Agus, & Fingerhood, 2018; Voklow, 2014; Kourounis et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

“…In an effort to provide OUD treatment to hard-to-reach populations, the Behavioral Health Leadership Institute (BHLI), a Baltimore non-profit organization dedicated to increasing access to behavioral health services for disadvantaged populations, established the Project Connections Buprenorphine Program (PCBP) in 2010. The PCBP is a treatment program based on a low-threshold and harm reduction care model that is housed within a community-based, peer-led recovery center (Daniels, Salisbury-Afshar, Hoffberg, Agus, & Fingerhood, 2014; Krawczyk et al, 2018). Services consist of an experienced clinical team of peer advisors, nurse, doctor, and social worker as well as other recovery supports.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Truong

Krawczyk

Dejman

et al. 2019

Addictive Behaviors

View full text Add to dashboard Cite

Objective: This qualitative study identifies and describes experiences and challenges to retention of individuals with opioid use disorder (OUD) who participated in a low-threshold combined buprenorphine-peer support treatment program in Baltimore. Methods: In-depth semi-structured interviews with staff and former clients of the Project Connections Buprenorphine Program (PCBP) (9 people) and focus group discussions with current and previous clients of PCBP (7 people) were conducted. Content analysis was used to extract themes regarding barriers to enrolling and remaining in, and transitioning from the program. Results: Primary challenges identified by the participants included struggles with cravings and symptoms of withdrawal, comorbid mental health issues, criminal justice system involvement, medication stigma, and conflicts over level of flexibility regarding program requirements and the role of employment. Conclusions: This study identified several obstacles clients face when seeking care through a combined bupre- norphine-peer support model. Findings highlight potential programmatic factors that can be improved and additional resources that may support treatment retention rates and better outcomes. Despite challenges, low- threshold and community-based programs can increase access to effective maintenance treatment for OUD, especially among vulnerable populations who may not have access to formal health services.

show abstract

“…Modern culture surrounding opioid use disorder has also changed. Recent studies confirm that treatment for OUD is most effective when comprised of multimodal interventions that are both pharmacological and psychosocial [ 43 ]. Therefore, peer-led support groups, community-wide prevention strategies, and stigma-reducing initiatives continue to develop and to demonstrate varying degrees of success in response to the opioid epidemic [ 44 , 45 ].…”

Section: Implications For Pain Medicinementioning

confidence: 99%

A Brief History of the Opioid Epidemic and Strategies for Pain Medicine

et al. 2018

View full text Add to dashboard Cite

The opioid epidemic has resulted from myriad causes and will not be solved by any simple solution. Consequent to a staggering increase in opioid-related deaths in the USA, various governmental inputs and stakeholder strategies have been proposed and implemented with varying success. This article summarizes the history of opioid use and explores the causes for the present day epidemic. Recent trends in opioid-related data demonstrate an almost fourfold increase in overdose deaths from 1999 to 2008. Tragically, opioids claimed over 64,000 lives just last year. Some solutions have undergone legislation, including the limitation of numbers of opioids postsurgery, as well as growing national prevalence of enhanced recovery after surgery protocols which focus on reduced postoperative opioid consumption and shortened hospital stays. Stricter prescribing practices and prescription monitoring programs have been instituted in the recent past. Improvement in abuse deterrent strategies which is a major focus of the Food and Drug Administration (FDA) for all opioid preparations will likely play an important role by increasing the safety of these medications. Future potential strategies such as additional legislative policies, public awareness, and physician education are also detailed in this review.

show abstract

Overcoming Medication Stigma in Peer Recovery: A New Paradigm

Cited by 48 publications

References 27 publications

“I Was Raised in Addiction”: Constructions of the Self and the Other in Discourses of Addiction and Recovery

“I Was Raised in Addiction”: Constructions of the Self and the Other in Discourses of Addiction and Recovery

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

A Brief History of the Opioid Epidemic and Strategies for Pain Medicine

Contact Info

Product

Resources

About