Symposia
Addictive Behaviors
Morgan Anvari, PhD
Research Coordinator
University of Maryland, College Park
Hyattsville, Maryland
Morgan Anvari, PhD
Research Coordinator
University of Maryland, College Park
Hyattsville, Maryland
Mary B. Kleinman, MS, MPH
Doctoral Candidate
University of Maryland
College Park, Maryland
Valerie D. Bradley, MPS
Research Coordinator
University of Maryland
College Park, Maryland
Dwayne Dean, Other
Peer Recovery Specialist
Project HEAL, University of Maryland
College Park, Maryland
Tolulope M. Abidogun, MPH
Research Coordinator
University of Maryland
College Park, Maryland
C. J. Seitz-Brown, PhD
Assistant Clinical Professor
University of Maryland
College Park, Maryland
Abigail C. Hines, BS
Research Coordinator
University of Maryland
College Park, Maryland
Annabelle M. Belcher, PhD
Assistant Professor
University of Maryland School of Medicine
Baltimore, Maryland
Aaron D. Greenblatt, MD
Assistant Professor
University of Maryland School of Medicine
Baltimore, Maryland
Julia W. Felton, PhD
Investigator
Henry Ford Health System
Detroit, Michigan
Jessica F. Magidson, PhD
Assistant Professor
University of Maryland
College Park, Maryland
Introduction: Substance use (SU) and methadone treatment (MT) stigmas are known barriers to successful opioid treatment outcomes, particularly among low-income, historically marginalized populations. Interventions led by peer recovery specialists (PRSs), individuals with lived SU and recovery experience, may be well suited to shift stigma-related barriers through shared experience. The current study sought assess shifts in stigma in patients in MT receiving an evidence-based intervention adapted for PRS delivery to support MT retention.
Methods: This study took place in a community-based MT program in Baltimore. We recruited patients who had recently started MT or demonstrated difficulty with MT adherence to participate in an open-label pilot study of a PRS-delivered behavioral activation intervention. Study participants completed stigma mechanism scale measures for SU and MT at baseline (BL) and post-treatment (PT). Paired-sample t-tests were conducted to compare stigma scores from BL to PT (~3 months) with the a-priori assumption of a difference in scores greater than zero (decrease in scores, one-sided test). Logistic regression was performed to evaluate association between change in stigma scores and 6-month retention in MT following study BL.
Results: Participants who had PT assessment (N = 28/37) identified as majority male (64.3%) and Black/African American (60.7%) with mean age 49.2 (SD 8.7). The PRS disclosed lived experience M = 1.54 (SD = 1.90) times per session. There was a significant decrease in total SU stigma scores from BL (M=2.56, SD=0.74) to PT (M=2.31, SD=0.78); t(26)=1.93, p=0.03). There was non-statistically significant reduction in total MT stigma scores from BL (M=2.10, SD=0.74) to PT (M=1.96, SD=0.68); t(20)=0.89, p=0.19). Differences in SU stigma were more pronounced among participants who completed all core intervention sessions and approached significance for pre-post decrease of MT stigma (t(17) = 1.53, p = 0.07). Controlling for BL stigma scores, PT scores did not significantly predict retention in treatment. Though not statistically significant, there was a trend in lower SU stigma (OR=0.196, 95%CI=0.008-1.667) and MT stigma scores (OR=0.081, 95%CI=0.0002-3.848) associated with higher 6-month retention rate.
Conclusions: PRS-led interventions may have potential to shift stigma-related barriers to MT retention. Change in stigma also may impact retention in MT. Future research should incorporate a comparison condition and test mechanisms by which a PRS may shift stigma in a larger sample size.
