Social support is associated with reduced stigma and shame in a sample of rural and small urban adults in methadone treatment

Background: Social support from family, friends, and others promotes retention, decreased substance use, and other positive outcomes for people in substance use treatment. Methadone treatment-related stigma makes social support vital for clients. Little is known about the relationships between stigma, shame, and social support for methadone treatment clients in rural and small urban communities. This study examines these relationships among such clients at an opioid treatment program (OTP) in Michigan. Methods: Adults (N = 267) at the OTP completed a web-based survey, including measures of general social support, friend support, demographic variables, opioid use-related shame, frequency of hearing negative comments about methadone treatment, past-year opioid use, and other variables not included in the present analysis. Multiple regression was used to examine associations between general social support (model 1), friend support (model 2) and other included variables. Results: Half of the participants (48.3%) reported past-year opioid use. In multiple regression analyses, male gender was inversely associated with general social support. Opioid use-related shame and experiencing treatment-related stigma were inversely associated with general social support and friend support. Conclusions: This study adds to the methadone treatment literature by highlighting how shame and stigma might be reduced amongst methadone treatment clients. Greater social support may reduce shame and stigma, making favorable treatment outcomes more likely. Clients with greater opioid-use-related shame and who more frequently experience treatment-related stigma may be particularly vulnerable and need additional supports to maintain recovery. Interventions to enhance support should thus address shame and stigma.