“I’m always hiding and ducking and diving”: the stigma of growing older on methadone

Abstract

Background There is emerging consensus that older opiate treatment patients have specific health and social care needs and also evidence of a particular stigma associated with opiate maintenance treatment. Yet, very little is known about the stigma experienced by individuals who have been interacting with methadone treatment services over a prolonged period. Aim and Method Conducted in Ireland and drawing on data from a qualitative study of 25 long-term clients of methadone treatment, this paper examines the stigma narratives of patients who are growing older as MMT patients. More than two-thirds were over the age of 40 and 16 had first accessed methadone treatment more than 20 years prior to taking part in the research. Findings The findings reveal the omnipresence of stigma in participants’ lives, which was experienced at institutional and public levels, leading many to attempt to conceal clinic attendance. Treatment-related stigma intersected strongly with the process of growing older on methadone; an ageing effect that was particularly apparent in participants’ accounts of public and private shame. The disabling effects of multiple intersecting stigmas were perhaps most apparent in participants’ narratives of internalized stigma, which uncovered private worlds characterized by isolation and seclusion. Conclusions The findings presented reflect the marginal position of addiction treatment within the wider healthcare system in Ireland and a failure to normalize methadone treatment.