Attitudes Toward Methadone Treatment Among Black/African Americans: Implications for Engagement and Retention

Despite its ability to lower the risk of opioid misuse, methadone is viewed by patients with a certain degree of ambivalence. Research has documented a variety of patient attitudes toward methadone, but the majority of these studies have relied on samples with little Black/African American representation. The primary goal of this study, therefore, was to identify and explain the attitudes of Black/African Americans toward methadone treatment. Surveys were used to identify which attitudes were most prevalent while interview data are presented to help explain and provide context to these attitudes. Data were drawn from the Florida Minority Health Survey, a mixed-methods project that included online surveys (n = 303) and in-depth interviews (n = 30). Only persons 18 years old or over who identified as Black/African American and reported past 90-day opioid misuse were eligible to participate. Analyses revealed that negative attitudes largely revolved around methadone's perceived helpfulness and side effects. The most strongly held attitudes were (a) methadone in a treatment program gets you high just like heroin, (b) the sooner a person stops taking methadone, the better, and (c) methadone is a "crutch." These findings contribute to the literature by improving our understanding of why some Black/African Americans may be ambivalent about methadone. Public Policy Relevance Statement This study is the first to examine methadone-related attitudes specifically among Black/African Americans. Our results document the extent and type of Black/African American's ambivalence toward methadone. Efforts are needed to address methadone-related stigma in Black/African American communities and the policy regulations (e.g., supervised daily dosing) that strengthen this stigma. Providers and policymakers would do well to consider the data presented in this article when developing interventions to destigmatize methadone among Black/African Americans.