Medical methadone maintenance: The further concealment of a stigmatized condition.
Item
-
Title
-
Medical methadone maintenance: The further concealment of a stigmatized condition.
-
Identifier
-
AAI9530884
-
identifier
-
9530884
-
Creator
-
Joseph, Herman.
-
Contributor
-
Adviser: Charles Winick
-
Date
-
1995
-
Language
-
English
-
Publisher
-
City University of New York.
-
Subject
-
Sociology, General | Health Sciences, Public Health | Sociology, Theory and Methods
-
Abstract
-
This study investigates the social and historical development of stigma directed to opiate dependent persons over the past century. Stigmatizing attitudes based on class and racial stereotypes in different historical eras have found expression in theories about opiate dependency, methods of treatment and punitive, controlling legal statutes. This is most evident when groups at risk for opiate dependency included poor men from non-white minorities and, white ethnic and immigrant groups.;One hundred socially rehabilitated methadone maintenance patients enrolled in a program called medical maintenance, an advanced phase of the methadone maintenance program for the treatment of heroin addiction, comprise the focal group of this study. These patients were transferred from highly regulated neighborhood clinics to private medical practices of internists affiliated with a hospital in New York City. Their reporting schedules were reduced from once per week to once per month, and procedures for dispensing methadone are implemented in the privacy of a physician's office.;Methadone patients harbor the invisible stigma of opiate dependency and are, as described by Goffman, discreditable but not discredited. A major finding of this study is that the program was successful for seventy-seven patients including ten who were successfully withdrawn from methadone. Although they either maintained or improved their levels of acceptable social functioning, the perception of social stigma remains.;Patients continue to conceal their treatment to avoid ostracism and loss of employment. The further concealment of methadone treatment in private medical practice and properties of methadone maintenance--the absence of narcotizing and tranquilizing effects--assist patients to pass as "normals." Patients and physicians concurred that methadone treatment was highly effective but that stigma and concealment were major problems. Stigma and misinformation hinder the delivery of adequate methadone treatment and prevent the expansion of the program despite its effectiveness in reducing transmission of the human immunodeficiency virus.;Community attitudes and the role of media in perpetuating stigma, myths and misunderstandings about methadone maintenance are investigated. An educational campaign targeted to the media, community, politicians and the professions highlighting outcomes of successful patients is needed to change current attitudes.
-
Type
-
dissertation
-
Source
-
PQT Legacy CUNY.xlsx
-
degree
-
Ph.D.
