MethaDON'T

What's up with denying Sober Housing to people on MAT??

Recently, while trying to find Sober Housing for a client who is on Methadone maintenance, I discovered that there's really a surprisingly fierce backlash against people on Methadone or Suboxone by the people running Sober Houses. The phone would ring, an intake person would pick up, and when I asked I would be told “Unfortunately, we don't take people on Methadone”. One place suggested that they actually had issues with people on MAT and it “wasn't really working out” for them to take them. No real issues were specifically brought up, but I have learned that the MAT crowd does get a bad rap for the few reasons that some people will sell their Suboxone for cash to drug-seeking people who hang around clinics, sometimes people on Methadone will try and trade it, and of course if you are nodding off from the drowsiness post-dose, you can't easily participate in programming, much of which becomes mandated in order for funding from funders who expect programs to be active and with full enrollment. Incentivizing often creates situations where some people will be there for the right reasons, whereas others will game the system if they can.

Let's be clear-A few bad eggs are shaping the dialogue around who gets access to Sober Living and who doesn't, and that's not a great look for inclusivity in the Recovery field. There's also a lot of myths about Methadone that need to be clearly refuted:

“Methadone is addictive”-Methadone is used to treat cravings, and is given in prescribed doses. Methadone is NOT an Opiate and so doesn't cause Opioid addiction.

“Methadone is just a way to get high”-Methadone doesn't make you high. Methadone taken as prescribed doesn't make you high.

“Methadone clinics draw crime and other issues”-Actually, there's no evidence to suggest that the presence of a MAT clinic is creating any increases in crime or violence. Data doesn't show any increases tied to Methadone Clinics unlike liquor stores and convenience stores that sell Kratom, which HAVE been linked to measurable increases in drug crime and violence.

This all leads me to ask, How do we combat the ongoing mythology around MAT to rehumanize and support people who use MAT as their recovery pathway? Again and again, I have heard from people in recovery from opiates that they've been shamed by NA and AA, or told they are substituting substances, or shamed when they are put on too large a dose of Methadone against their desires and DO start nodding off (Generally, on a managed steady dose you cannot see Methadone users falling asleep suddenly and unexpectedly). It seems to me that the real reason places won't take people on MAT has more to do with biases then fact. I just don't understand whether there's an actual argument to be made as to why to bar MAT users from Sober Living or not because, frankly, nobody has actually posited why there's an issue and what that issue is. Until we have clarity on what MAT users pose a threat to, we just don't know.

NOTE: If you run a Sober Living community, I'd love to give you the opportunity to clear the air. I extend an offer to run an addendum to this piece if you can give me clear evidence of negative effects tied directly to MAT usage.