syringe and pills

Pittsburgh zine project aims to reduce stigma around opioid use disorder treatment

Pittsburgh City Paper – A group of Pittsburgh recovery advocates are using an unconventional method to reduce stigma around a life-saving addiction treatment.

A new zine titled “Using Medication For Opioid Use Disorder?: A Guide to Surviving and Thriving in the Pittsburgh Area” compiles resources and personal stories of people who use or have used medications for opioid use disorder — or MOUD, for short — to recover from opioid addiction. It also aims to bust some common myths about MOUD that contribute to its stigma.

The group also plans on launching a new online recovery group — based on the Medication-Assisted Recovery Anonymous (MARA) model — specifically for people using MOUD.

Jessica Williams, a former coordinator of Pittsburgh’s annual Recovery Walk, initiated the MOUD zine project with grant funding from Life Unites Us, aiming to eradicate the stigma associated with MOUD by supporting people in recovery to “come out” about their experiences with MOUD.

“I really believe in the power of people openly telling their stories, not just about recovery, but about all kinds of stigmatized experiences or conditions,” Williams tells Pittsburgh City Paper.

But, she acknowledges, overcoming negative perceptions to talk publicly about a stigmatized experience is far from easy. Every year for the last several years, Williams says she has struggled to find Recovery Walk speakers willing to talk publicly about their experience with MOUD.

“I felt like if I kept getting speakers that didn’t use medication, it was like contributing to the problem,” she says, feeling as though it failed to highlight MOUD as a life-saving recovery method of equal legitimacy to abstinence or other kinds of recovery.

In 2022, Williams convened a group of people with MOUD experience and their allies to figure out how to support people in recovery who take MOUD to tell their stories and raise awareness about how helpful these medications can be.

Medications for opioid use disorder, such as methadone and buprenorphine products like Suboxone or Sublocade, are evidence-based treatments for people who want to stop using opioids. These medications are designed to address the physiological effects of opioid addiction, like cravings and withdrawal symptoms so that people can focus on their recovery.

Research suggests MOUD can reduce the risk of fatal opioid overdose by as much as 80% and lower the risk of contracting HIV or Hepatitis C. Yet, despite the fact that these medications are the most effective treatment out there for opioid use disorder, they are highly stigmatized, even within recovery communities.

People who have benefitted from MOUD who spoke to City Paper for this story describe experiencing a double stigma, both the stigma of dealing with addiction and an added prejudice against MOUD, which they feel is driven by myth and misunderstanding.

The group Williams convened decided they wanted to put together a useful educational tool created by people with personal experience with the issue. They decided on a zine because of the medium’s grassroots, DIY vibe.

The zine addresses many common myths about MOUD, including that MOUD is just “replacing one drug for another,” and that people using MOUD are less stable than those pursuing abstinence-based recovery.

Kenneth Clowes, who contributed to the zine project, tells City Paper that he wanted to quit using drugs after the first year of his addiction to opiates, but it took him over ten years to successfully quit, which he eventually did with the help of MOUD.

“At one point, I felt like recovering a happy and healthy life was just not possible,” Clowes says. “Taking MOUD helped me remember that it was possible. The medications helped stabilize the intense cravings I was experiencing multiple times a day. It allowed me to rejoin the workforce and take care of myself financially.”

Although MOUD tangibly helped him get his life back together, he felt judgment from family, friends, and even other people in recovery for choosing medication rather than complete abstinence. “I felt guilty for taking something that was actually helping my problems,” he says.

Clowes says he was able to successfully stop taking MOUD after a year or two but would “still hear people talking down at those trying to better their lives with these medications.”

“I knew how much hearing that type of talk did not help me, my self-esteem, or my recovery and I felt the need to help my friends who were taking MOUD recover. So, I began to speak publicly about its benefits. I realize it may be easier for someone who no longer takes MOUD to speak about it then someone who is currently taking it because of the stigma that still exists,” he says.

The zine also includes strategies for “coming out” as a person who has benefitted from MOUD, a list of safe spaces for people in recovery taking MOUD, and short personal stories from zine contributors.

Although it may seem like fairly niche advice, contributors to the project emphasize that reducing stigma around MOUD is in everyone’s best interest.

“Addiction is, essentially, a public health crisis. This is not a crisis of individual moral failing or even individual disease. It is a collective problem,” local writer Sarah Shotland, who participated in the zine project, tells City Paper.

She adds, “If people are interested in living in a safer, healthier world and are interested in what our neighborhoods could look like, our communities, our schools, et cetera, could look like without the terrible tragedy of addiction and all its concomitant tragedies — everything from the cost on our healthcare system to mass incarceration to the child welfare system — that all is helped by MOUD. Because MOUD are statistically what leads to the most people getting help long term. So that helps all of us.”

Over the summer the group did one small printing of the zine and are looking forward to printing more this fall with funding from the Staunton Farm Foundation. They also hope to give the project more of an internet presence.

Paired with the zine effort, they’re also launching a weekly 12-step meeting explicitly intended to be a supportive, nonjudgmental space for people using MOUD in their recovery. Those interested in attending the meeting, which takes place every Thursday evening, can email to get involved.

Clowes hopes this zine project and starting the MARA-type meeting will be positive steps towards eradicating the stigma against MOUD in Pittsburgh.

“If we can begin to acknowledge each other’s pain and get curious about opposing beliefs instead of just dismissing each other right away, we can begin to create a space for exploration and dialogue,” he says. “That is space is where minds are changed.”

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