ORCID

0000-0003-0860-1428

Keywords

stigma; peer support group; medication for opioid use disorder; Medication-Assisted Recovery Anonymous; Alcoholics Anonymous; Narcotics Anonymous

Abstract

The United States continues to face an opioid epidemic, with over 80,000 opioid overdose deaths reported in 2023. Although medications for opioid use disorder (MOUDs) are effective treatments for opioid use disorder (OUD), stigma remains a major barrier to their adoption. People taking MOUDs often feel stigmatized within traditional 12-step peer support groups like Alcoholics Anonymous or Narcotics Anonymous (AA/NA), potentially harming the recovery process. Medication-Assisted Recovery Anonymous (MARA) was recently developed as an alternative 12-step support group explicitly open to people using MOUD.

This qualitative mixed methods study retrospectively examines how MARA meetings differ from AA/NA meetings, based on interviews with former AA/NA participants. People using MOUD in MARA with a history of AA/NA attendance were recruited through email messages to MARA leaders, followed by snowball sampling, and then screened via online survey to assess meeting inclusion criteria. Individuals meeting the inclusion criteria (n=19) were invited to participate in semi-structured virtual or telephone interviews assessing their experience with MOUD stigma in peer support groups. Additionally, a convenience sample of nine online meetings (three each of AA, NA, and MARA) were observed with ethnographic notes taken. Interview data and ethnographic notes were analyzed for themes using iterative categorization. All qualitative results (observations, screening survey, and interviews) were then integrated to create final themes.

Participants felt MOUD was less stigmatized in MARA than in AA/NA. Participants believed MARA and AA/NA differed in their definitions of recovery and relapse, attitudes toward MOUDs, emphasis on continued involvement in the support group, reliance on a Higher Power versus individual power, how participants learn of the group and continue participating in the group, and flexibility of the meeting structure. Observation findings supported interview themes. Healthcare providers should discuss MARA as a peer support alternative to AA/NA, should discuss navigating MOUD stigma in peer support groups generally, and could offer MARA onsite.

Completion Date

2025

Semester

Spring

Committee Chair

Andraka-Christou, Barbara

Degree

Doctor of Philosophy (Ph.D.)

College

College of Community Innovation and Education

Department

Public Affairs

Identifier

DP0029410

Document Type

Dissertation/Thesis

Campus Location

UCF Downtown

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