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National Guidelines for Behavioral Health Crisis Care – A Best Practice Toolkit
Knowledge Informing Transformation
Interview 7 Anonymous Peer Recovery Coach
Peer Recovery Coach Says “Stigma of MAT Persists in the Recovery Community”
Veronica* slid into addiction slowly, increasingly drinking as a teen, and by the time college came
around, she needed alcohol first thing in the morning to stop her hands from shaking. She says it
escalated from there. For Veronica, addiction wasn’t a straight line, more like there were times
she stopped entirely and others when there was a litany of drugs she used each day, including
heroin and oxycodone. She quit multiple times, promising her family she was done, but it wasn’t
until a close friend died in front of her, his arm hanging limply off the EMS gurney, that Veronica
made a promise to herself for herself that she was going to get help. She turned a corner that
day, driving to a nearby clinic where she started Medication-assisted treatment (MAT) and that,
she says, “was all she wrote.” It’s not though, because six years later, Veronica is now an award-
winning peer recovery coach, helping people navigate the challenges she faced. When asked
what or who she credits for her recovery, Veronica doesn’t hesitate to say ongoing MAT and
caring recovery coaches, but, she lowers her voice, her colleagues don’t know. She fears they
wouldn’t accept her and she has good reason to think so. “There’s a lot of stigma within the
recovery world and a belief that MAT is simply substituting one drug for another.” Veronica says
in a recent discussion, a colleague said just that. “It’s startling because no one would say that
about a person with a physical illness. Can you imagine if those in the medical field said to people
with diabetes, ‘You shouldn’t use insulin as treatment.’ Well, that’s what’s happening in the field
of recovery: people are often judged for using evidence-based medicine.”
The belief that MAT is exchanging one drug for another is not uncommon among the general
population and even among physicians in the medical field. In May 2017, Dr. Tom Price, former
Secretary of Health and Human Services, said, “If we’re just substituting one opioid for another,
we’re not moving the dial much.” He faced immediate backlash from the medical and scientific
community. Dr. Vivek Murthy, former Surgeon General of the United States, responded on
Twitter that an abstinence-only approach isn’t backed by science, unlike MAT, which leads to
better outcomes compared to behavioral treatment alone. Months later, in September, there
appeared to be a shift in the federal government, with Dr. Scott Gottlieb, the FDA Commissioner
at the time, saying that MAT “…is one of the major pillars of the federal response to the opioid
epidemic in this country. He went on to say that MAT is an essential tool that has the potential
to allow millions of Americans to regain control of their lives.
What’s surprising to Veronica isn’t that people in the general population don’t understand that
MAT is an evidence-based practice but that those working in recovery are perpetuating
misinformation. Medication-assisted treatment is a holistic approach for substance use disorders
that combines counseling, behavioral therapy, and FDA-approved medication. She says that
without MAT, she would likely be dead. “I would have continued using, or relapsed, unsure of
what I was taking and the dosage. Heroin is no longer pure. It’s increasingly packed with other
ingredients, many of them potentially lethal, like Fentanyl.” Veronica says that without
treatment, she wouldn’t have been able to enter recovery because the pain associated with
withdrawal is horrendous. It’s not just acute pain that’s problematic, but also precipitated
withdrawal that happens months later, making each day unbearable. “People in recovery who
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