Stigmatization Inherent in Addiction Treatment:

A comment from a long-term, thoughtful provider of "substitution" treatment in Germany, and one that applies in most countries (most particularly the US): "Wherever we fight for a better treatment of addicted patients, our goal should be the same as the ones we apply to the treatment of all other chronic diseases. Three common violations of this principle:

- The considerable centralization/concentration of patients in specialized 'programs' is suboptimal and in many ways counterproductive. Part of the healing process for many involves new relationships and the ability to be integrated into all segments of society - including the medical care system..

- The attitude of many government officials, insurers and clinicians (including, perhaps most of all, addiction treatment providers) that patients should be grateful for what they get, accept the fact that there will be many associated restrictions, and an expectation that all "rules" must be followed, including abstaining from non=prescribed drugs/medicine, and that non-compliance will lead to therapeutic abandonment.

- Policies and practices that reflect mistrust towards all patients, regardless of treatment duration or individual therapeutic response. (In the US the most glaring example may be the demand of the federal government that every methadone maintenance patient, forever, submit no less than 8 urine specimens per year, and the insistence of many programs that urine be provided under the direct observation of staff)."