Methadone as Social Control : Institutionalized Stigma and the Prospect of Recovery

Julie Harris, Karen McElrath

Research output: Contribution to journalArticlepeer-review

137 Citations (Scopus)
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Methadone maintenance treatment (MMT) is an intervention used to treat opioid (heroin) dependence. Several investigators have found that MMT is effective in reducing heroin use and other behaviors; however, a disproportionate number of MMT clients leave treatment prematurely. Moreover, MMT outcome variables are often limited in terms of their measurement. Utilizing an integrated theoretical framework of social control and stigma, we focused on the experiences of methadone maintenance from the perspective of clients. We pooled interview data from four qualitative studies in two jurisdictions and found linkages between social control and institutional stigma that serve to reinforce “addict” identities, expose undeserving customers to the public gaze, and encourage clients to be passive recipients of treatment. We discuss the implications for recovery and suggest recommendations for change.
Original languageEnglish
Pages (from-to)810–824
Number of pages14
JournalQualitative Health Research
Issue number6
Publication statusPublished (in print/issue) - 9 Jan 2012


  • Heroin dependency
  • Addiction
  • Substance use
  • Health care
  • Service user experiences
  • Recovery
  • Stigma
  • Social Control
  • Social identity
  • Treatment outcome
  • Methadone


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