Column: Stigma Around Opioid Maintenance Therapies Harmful for Communities

Last week, I talked to Lori Macasa, assistant clinic director of the Lynchburg Treatment Center, about the rise in opioid addiction and abuse within Lynchburg City and surrounding counties.

The opioid epidemic is something that many have seen and heard about happening in the northeast and places in West Virginia, but not a lot know about how bad the problem is in the Lynchburg area, Macasa said.

I went into the conversation expecting to talk about problems like a lack of public funding for fighting back the influx of opiates into the city, or perhaps about the prevalence of relapse among addicted persons. The research I had done about the epidemic beforehand indicated to me that the problem in Lynchburg was not as big as in places in West Virginia, but that it was still prevalent.

Walking out of the treatment center after a 30-minute talk on heroin and fentanyl, though, I came away with an understanding of a problem associated with the opioid epidemic that I had not previously considered: a widespread stigma among treatment facilities and the victims of opiate abuse.

It may seem nonsensical that a facility dedicated to treating people addicted to opiates could have a negative association with it. But Macasa said one of the biggest hurdles the treatment facility faces is overcoming a stigma that by treating opioid addiction with a synthetic opiate replacement, that they are just trading out one drug for another.

Such a belief — which Macasa said is prevalent within many in the Lynchburg medical and public health community — is not only abhorrently uneducated, but also pernicious to community-led efforts to stop the opioid epidemic.

Despite corroborated scientific evidence from the CDC and FDA that show opioid maintenance therapies like the ones that are used at the Lynchburg Treatment Center are low-cost, effective strategies at combating opiate addictiveness, there still remains a lingering fight among some to limit public support of such remedies.

Upon understanding this and researching the “controversy,” I could not fathom that even with such a seemingly rudimentary idea — that the opioid epidemic is bad, and we should fix it — that society has found yet another avenue to ignore factual evidence in support of blatant ignorance that in turns fractures our communities into two sides.

It is as if the completely illogical claims that vaccines cause autism and that global warming is a myth are not enough. Our society is utterly captivated by mendacity.

The argument that it is bad practice to treat the addiction to hard opiates like heroin and fentanyl with synthetic opiate replacements, at its heart, is a mischaracterization and lack of understanding of opiate addiction in general.

Like many addictions, opiate addiction is a disease of the brain, not just as a bad habit that can be stopped if addicted persons would just “get their life together.” Believing that victims of opiate addiction have to “just try harder” to kick their addiction is a symptom of either an unconscious manipulation of facts or willful ignorance. I’m not sure which one is worse.

Either way, such a belief perpetuates an insensitivity that allows people unaffected by the opioid epidemic an excuse to demean and stigmatize those who are addicted.

It strips victims of opiate addiction of their human dignity: he is no longer a husband and father who lost his family and support system after gradually becoming more dependent on opiates to the point of using heroin, but a druggie who deserves what happened to him because “only bad people use drugs.”

This mindset undermines community support systems that could actively fight the heroin epidemic; instead of solidifying efforts to end the epidemic as a wholistic community, people are divided and no long-lasting solution is ever achieved. In Lynchburg and its surrounding counties, the result is a stark increase of addiction and overdoses.

After talking with Macasa about this problem rather extensively, she finished by saying she’s optimistic. I’m so grateful that she and others like her are in the positions they are, because for myself, I am not so sure. It’s hard to see the light at the end of the tunnel when the epidemic is a health crisis in cities and states across the country and is only getting worse.

It’ll probably always be impossible to completely eradicate the opioid epidemic altogether, so really, my hope is not that we can get rid of the problem, but that maybe through a greater sense of understanding and dedication, we as a community can at least make a difference.