Messages About Methadone and Buprenorphine in Reality Television: A Content Analysis of Celebrity Rehab With Dr. Drew

Abstract

Medication-assisted treatment for opioid dependence is safe and effective, yet negative perceptions about methadone and buprenorphine may discourage patients from entering treatment. One source of information that may influence viewers’ perceptions is television. We performed a content analysis of a popular reality television program on addiction treatment. Although many patients had histories of opioid use, there were no positive messages about methadone or buprenorphine. The two main messages were that they (1) are primarily drugs of abuse, and (2) not acceptable treatment options. These messages reinforce negative stereotypes and may perpetuate stigma. There were multiple missed opportunities to provide evidence-based information.

RÉSUMÉ

La Méthadone et la Buprénorphine dans la télé-réalité : une analyse du contenu des Celebrity Rehab avec le Dr Drew

La médication assistée par un traitement contre la dépendance aux opiacés est sûr et efficace, mais les perceptions négatives au sujet de la Méthadone et la Buprénorphine peuvent décourager les patients de commencer un traitement de ce type. L'une des sources d'information qui peut influencer l'avis du grand public est la télévision. Nous avons effectué une analyse du contenu d'un programme de télé-réalité connu parlant du traitement contre la toxicomanie. Bien que de nombreux patients aient eu des antécédents en terme de consommation d'opiacés, il n'y avait pas des messages positifs au sujet de la Méthadone ou la Buprénorphine. Les deux principaux messages étaient que 1) ces 2 produits sont principalement des drogues abusives, et 2) ils sont des traitements inacceptables. Ces messages renforcent les stéréotypes négatifs et risquent même d'en augmenter la stigmatisation. Ce furent diverses occasions manquées de fournir des informations factuelles et concrètes.

RESUMEN

La metadona y la buprenorfina en los programas de realidad: un análsis del contenido de Celebrity Rehab con el Dr. Drew

El tratamiento con la ayuda de medicamentos para la dependencia de opioides es seguro y eficaz, sin embargo, las percepciones negativas acerca de la metadona y la buprenorfina pueden disuadir a los pacientes de iniciar tratamiento. Una fuente de información que pueda influenciar en las percepciones es la televisión. Se realizó un análisis del contenido del un programa de televisión del género realidad sobre el tratamiento de la adicción. A pesar de que muchos de los pacientes tenían historias clínicas del uso de opioides, no hubo mensajes positivos sobre la metadona o la buprenorfina. Los dos mensajes principales fueron que 1) la metadona y la buprenorfina son mayormente drogas de abuso y 2) no son aceptables como opciones de tratamiento para la adicción. Estos mensajes reafirman los estereotipos negativos y pueden perpetuar el estigma. Hubo múltiples oportunidades perdidas de proporcionar información basada en evidencia.

Keywords :

• methadone
• buprenorphine
• opioid dependence
• television
• media messages

Notes

1 Treatment can be usefully defined as a unique, planned, goal directed, temporally structured, multi-dimensional change process, which may be phase-structured, of necessary quality, appropriateness and conditions (endogenous and exogenous), implemented under conditions of uncertainty, which is bounded (culture, place, time, etc.), which can be (un)successful (partially and/or totally), as well as being associated with iatrogenic harm and can be categorized into professional-based, tradition-based, mutual-help based (AA,NA, etc.) and self-help (“natural recovery”) models. Whether or not a treatment technique is indicated or contra-indicated, and its selection underpinnings (theory-based, empirically-based, “principle of faith-based, tradition-based, budget-based, etc.) continues to be a generic and key treatment issue. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) and “wellness” treatment-driven models there are now new sets of goals in addition to those derived from/associated with the older tradition of abstinence- driven models. Conflict-resolution models may stimulate an additional option for intervention. Treatment is implemented in a range of environments; ambulatory as well as within institutions which can also include controlled environments such as jails, prisons and military camps. Treatment includes a spectrum of clinician-caregiver-patient relationships representing various forms of decision-making traditions/models; (1). the hierarchical model in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive, (2) shared decision-making which facilitates the collaboration between clinician and client(s)/patient(s) in which both are active, and (3) the ‘informed model’ in which the patient makes the decision(s).

There are no unique models or techniques used with substance users - of whatever types and heterogeneities- which aren't also used with non-substance users. Editor's note.