Stigma and perceptions of recovery in Scotland: a qualitative study of injecting drug users attending methadone treatment

The purpose of this paper is to explore how injecting opiate users on a methadone treatment programme experience stigma as drug addicts, and as service users in health care and pharmacy settings. In particular the paper explores the rationale for injecting drugs, which the paper is argued to create the conditions for experiencing shame at the micro interactional level, influenced by macro institutional factors. The paper links this issue of being an injecting drug user in treatment to question whether the definition of recovery as “drug free” in the Scottish drug policy document The Road to Recovery (2008) creates the potential for stigma of service users receiving methadone maintenance treatment.

In all, 14 participants, all of whom identified themselves as problem intravenous users of drugs, were recruited from three voluntary sector (third sector) treatment agencies in Scotland. Participants took part in semi-structured interviews; these were recorded, transcribed and qualitatively analysed thematically.

Participants describe feelings of stigma in relation to their drug taking as problem users. Their experiences as recovering opiate injectors raises further challenges in distancing themselves from stigmatised addict identities.

Reasons for injecting rather than smoking heroin were principally financially challenging a widely held belief that users inject primarily for pleasure, which is argued as increasing the potential for stigma. Shame and perceived discrimination was documented before and during drug treatment.