I. The Stigma and Impact
Michele Donato tried everything she could to enter recovery. She had been in and out of rehab about 20 times, but to her dismay, nothing seemed to stick. Finally, in 2015, her case manager recommended she try medication to help her maintain sobriety. She decided to give methadone a chance.
Now, Donato is one of 49 people living in the Joy of Living recovery residence in Frankford. She has been in recovery for 18 months and said she finally has some stability in her life.
But it has come with challenges. Like many other people in recovery who use medication-assisted treatment, Donato had trouble finding a recovery house that accepted people who use MAT.
Joy of Living is one recovery residence in Philadelphia that offers housing to people using either methadone or buprenorphine, which is known more commonly by its brand name Suboxone. Of 23 private recovery residence programs identified by the Pennsylvania Alliance of Recovery Residences in Philadelphia, nine allow certain kinds of medication. Of those, only three allow people taking methadone. And in residences that do accept MAT, beds are increasingly difficult to find as the number of people taking these medications increases.
The Substance Abuse and Mental Health Services Association defines medication-assisted recovery as the use of medication approved by the Food and Drug Administration and behavioral therapies to treat substance use disorder. Methadone, Vivitrol and Suboxone are the only three FDA-approved medications used to treat opioid addiction.
A 2015 report from the Society for the Study of Addiction showed MAT cut death rates among people in recovery by 50 percent.
Some public recovery residences and a growing number of private ones are changing their policies to reduce the stigma around and provide housing for people who use MAT.
Donato said the stigma is powerful — it made her reluctant to even try MAT.
“I didn’t do it all those years because of the stigma,” Donato said. “I didn’t want to be looked upon any different.”
Early on in her use of MAT, she experienced that stigma firsthand. In Chester County, where she lived, Donato couldn’t find a recovery house that supported her treatment method.
On the PARR resource manual of private recovery programs, there aren’t any recovery residences in Chester County that allow methadone.
“I was homeless, because where I’m from we didn’t have resources like that, so I was in and out of rehab,” Donato said. “Then I choose to move to Philadelphia. I got hooked up with Joy of Living, and they gave me the chance to get a job, get money to pay my rent and get hooked up with a lot.”
Fred Way, PARR’s executive director, said operators of independent recovery residences can decide whether to admit people using MAT.
“The disparities come from lack of education on medication-assisted treatment, and if people don’t know, they just assume the worst,” Way said. “People feel as though if somebody is on MAT, they’re getting high, but really they’re not. It is actually a life-saving medication and people need to realize that.”
II. Joy of Living
Stephanie Scully, the founder and executive director of Joy of Living, opened her doors to people using MAT in 2013 because it was more commonly used, and she saw it was successful.
Scully, who is also a certified recovery specialist and a person in long-term recovery, said the research and statistics regarding MAT should be enough for people to acknowledge it as an effective form of treatment.
“There’s just this huge uneducated population that doesn’t understand that it’s an evidence-based practice for people who are sustaining long-term recovery,” Scully said.
Lori LaPorte, the Joy of Living program manager and a person in long-term recovery, said people are often opposed to MAT because it wasn’t a part of their recovery.
“I was not a proponent of MAT because I was a previous recipient of MAT in years past, and I absolutely abused the system,” LaPorte said. “But in recent years, we have been facing an epidemic. We lose people on a regular basis in this neighborhood. Data has shown that MAT is keeping people alive, and so there needs to be a place for people to go while they travel that journey.”
“When you put peoples’ lives on the line based on opinion, that’s not right,” she added.
At Joy of Living, people who use MAT live alongside people who don’t. Scully said this helps the MAT residents feel less segregated.
“If you isolate them, you’re stigmatizing,” Scully said. “I’d rather work together as a community. They’re intermingled. We are a family at Joy of Living, so everybody has their own pathway.”
III. Way of Life
The idea that there are several ways that individuals can enter recovery has opened more doors to housing for people who use MAT. When Barb Williamson realized not everybody has to follow the same recovery plan, she shifted her perception of medication.
Williamson is the president and owner of Way of Life, a network of recovery residences in Pennsylvania. She didn’t originally support MAT because her personal recovery was abstinence-based.
But a Facebook status posted by Brooke Feldman, a person in long-term recovery who advocates for MAT patients, made Williamson reconsider MAT as a solution.
Feldman’s status, posted on Nov. 15, 2017, confronted recovery residence owners who don’t allow the use of MAT.
The post stayed with Williamson after she read it. Every time she saw Feldman’s name on her Facebook feed, Williamson said she felt annoyed and angry.
But old advice given to Williamson from her sponsor in a 12-step group helped her analyze the situation differently, and ultimately better understand why she felt so attacked by the social media post.
“My sponsor always said, ‘If you don’t like how someone acts, you got to look into it because it might be a reflection of yourself,’” Williamson said.
After doing her own research, Williamson said she understood the positive impact of MAT. Williamson is now preparing to open up seven Way of Life residences Delaware County during May 2018, all of which will accept people using MAT.
The Department of Behavioral Health and Intellectual disAbility Services in Philadelphia is also working to make recovery housing more accessible to MAT residents.
Roland Lamb, the deputy commissioner of DBHIDS, said there are 17 recovery residences funded by the Office of Addiction Services that accept residents who use MAT.
“We are slowly and surely building that collection of recovery houses,” Lamb said.
For now, the handful of recovery residences in Philadelphia that accept people who use MAT continue to give hope to people like Donato, who said she is still looked down upon, despite maintaining her recovery for a year and a half.
Donato recently attended a 12-step meeting and said she felt uncomfortable sharing her story. In the past, she has felt that people dismiss her recovery because she takes methadone.
“People wouldn’t pay a bit of attention to me,” Donato said. “The eyes roll and all of that.”
These feelings of discrimination brought tears to her eyes. But knowing that she has a place to call home helped reestablish Donato’s confidence.
“It feels great to have a support system here that truly does care about your recovery process,” Donato said. “It’s your recovery, it’s not their recovery.”
“With the epidemic out there there’s probably going to be a lot more people on methadone,” she added. “And that’s something recovery houses need to pay attention to.”