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Purpose: This paper reviews and integrates the
literature on the stigma associated with opioid use disorder (OUD) and how this
acts as a barrier for patients seeking Medication Assisted Treatment (MAT). Implications for patients in rural areas who
face stigma for opioid use disorder are reviewed. Methods: We examine the extant literature since 2007,
reviewing studies focused on the stigma against patients suffering from OUD and
MAT. Findings: The review
identifies five categories of sources of stigma that research has
addressed: Stigma against the patient; stigma
by nurses; stigma by primary care physicians; stigma from counselors; stigma by
pharmacy and dispensary staff; stigma against MAT by drug courts, stigma by
family members, coworkers, and employers. Conclusions:
Stigma exists as prejudice, negative stereotypes and associations, and labels.
Despite widespread evidence supporting Methadone Maintenance Therapy (MMT) and
Buprenorphine Maintenance Therapy (BMT) effectiveness, stigma abounds within
the medical community and society at large. Discriminatory practices, poor
relationships with dispensing staff, pharmacists, counselors, and doctors, and
a feeling of being separate or “alien” from others are cited as barriers to
involvement and participation in MAT. This has created disparities in health
care outcomes as well as the access and availability of MAT services. Rural patients experience these sources of
stigma and face a heightened barrier to access for MAT services. However, the primary care setting along with
delivery of care through primary care physicians, physician assistants, and
nurse practitioners offers a means to increase care in rural areas.