Jo L. Sotheran, PhD, Research Consultant, 25 Plaza St., Brooklyn, NY 11217, (718) 398-4729, JSotheran@aol.com

Effective advocacy for the needs of substance-using populations and their treatment is increasingly important in an era of strained budgets and managed care. Medication-Assisted Treatment (MAT) and its dominant modality, methadone treatment, are among the largest addiction treatment modalities in parts of the U.S., noted for their ability to reach a high-need population, and backed by an extensive scientific literature. Nonetheless, even more so than in the case of other treatment modalities or "recovery" in general, it has proved difficult to develop a public presence and advocacy movement on behalf of MAT. Based on experience and observation in three major parts of the MAT "system" and drawing upon selected concepts from sociology of organizations and the sociology of health and illness, this presentation uses the example of emerging MAT advocacy to review some key dimensions in developing models for advocacy. MAT advocacy has suffered from disadvantages in all the key elements illustrated: the makeup of the population treated; conflicting beliefs about addiction among treatment professionals, treatment population, and public; multiple and cumulative stigma processes around the treatment, its providers, and those treated; difficulty identifying common concerns within treatment population and with providers; limited mechanisms to communicate, educate, and organize around common concerns; and the complexity and decentralization of regulatory and funding environments. Successful advocacy development is not "one size fits all." It should be preceded by assessment of the nature of the population represented and the organizational and practical resources available.

Learning Objectives:

• Identify two key characteristics of MAT that distinguish it from other common types of addiction treatment.
• Describe ways in which stigma may operate to label treatment as well as those receiving treatment.
• Explain the importance of beliefs about addiction in how different types of addiction treatment may be understood.

Keywords: Advocacy, Methadone Maintenance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.