Underutilization of medications to treat opioid use disorder: What role does stigma play?

Subst Abus. 2019;40(4):459-465. doi: 10.1080/08897077.2019.1640833. Epub 2019 Sep 24.


There is consensus in the scientific literature that the opioid agonist medications methadone and buprenorphine are the most effective treatments for opioid use disorder. Despite increasing opioid overdose deaths in the United States, these medications remain substantially underutilized. For no other medical conditions for which an effective treatment exists is that treatment used so infrequently. In this commentary, we discuss the potential role of stigma in the underutilization of these opioid agonist medications for addiction treatment. We outline stigma toward medications for addiction treatment and suggest that structural and policy barriers to methadone and buprenorphine may contribute to this stigma. We offer pragmatic public health solutions to reduce stigma and expand access to these effective treatments.

Keywords: Opioid use disorder; buprenorphine; health policy; methadone; stigma.

MeSH terms

  • Buprenorphine / therapeutic use
  • Health Policy
  • Health Services Accessibility / statistics & numerical data
  • Health Services Misuse / statistics & numerical data*
  • Humans
  • Methadone / therapeutic use
  • Opiate Substitution Treatment / psychology*
  • Opiate Substitution Treatment / statistics & numerical data
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Social Stigma*
  • Treatment Outcome
  • United States


  • Buprenorphine
  • Methadone