Karen McElrath and Julie Harris: Institutional stigma and the delivery of methadone maintenance

Methadone maintenance treatment (MMT) is widely recognised as an intervention that is used to treat opioid (namely heroin) dependence. It is highly regulated and is available in both North/South Ireland.  Using data collected in four different studies in North/South Ireland, we describe clients’ experiences with MMT.  Methadone provision in both jurisdictions was characterized by social control and institutional stigma, that served to reinforce “addict” identities, expose “undeserving” patients to the public gaze, and create barriers to reintegration. We discuss these findings in terms of the challenges for policymakers and service providers.

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