ArticleAddiction (Abingdon, England)2020
Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS).
Article in Addiction (Abingdon, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stigma in substance-based and behavioural addictions: A systematic review.Journal of behavioral addictions · 2025Pooled it
- Trust in addiction treatment services among people who use drugs in Vietnam.Journal of substance use and addiction treatment · 2026Trial
- Personally-tailored opioid-overdose and medication for opioid use disorder (MOUD) education (TOME) significantly increases MOUD and overdose knowledge in peripartum individuals: Results from a randomized controlled pilot trial.Drug and alcohol dependence · 2025Trial
- Disclosing Recovery: A pilot randomized controlled trial of a patient decision aid to improve disclosure processes for people in treatment for opioid use disorder.Journal of substance use and addiction treatment · 2024Trial
- Development and Validation of a Provider-Specific Anticipated Stigma Scale for People Who Inject Drugs.AIDS and behavior · 2026Article
- Patient Trust in Healthcare Providers among People on Methadone Maintenance Treatment Using Methamphetamine in Vietnam.Substance use & misuse · 2026Article
- Harm reduction engagement and ongoing opioid use among adults receiving methadone or buprenorphine in Philadelphia.Harm reduction journal · 2026Article
- Impact of a brief personally tailored opioid-overdose and medication for opioid use disorder education intervention on naloxone acceptance in peripartum individuals: A secondary exploratory analysis.Journal of substance use and addiction treatment · 2025Article
- "Stigma is our most powerful enemy": Understanding opioid use disorder stigma and the role of peer support in rural Maryland.The International journal on drug policy · 2025Article
- Predictors of Enacted Stigma Following Disclosure Among People in Recovery From Opioid Use Disorder: A Machine Learning Approach.Journal of substance use · 2025Article
- Psychometric performance of tools to measure internalized drug use stigma among people who use drugs and people on medication-assisted treatment in Dar es Salaam, Tanzania.Drug and alcohol dependence · 2024Article
- Drug Overdose Death Following Substance Use Disorder Treatment Termination in New York City: A Retrospective Longitudinal Cohort Study.Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- U.S. Healthcare Workers' Perspective of Outpatient Provision of Methadone: A Scoping Review.Substance use & addiction journal · 2024Article
- Reduction in substance use stigma following a peer-recovery specialist behavioral activation intervention.The International journal on drug policy · 2024Article
- Substance use stigma: A systematic review of measures and their psychometric properties.Drug and alcohol dependence reports · 2024Review
- Internalized Stigma Measurement in Substance Use Treatment Settings: A Narrative Review.Addiction research & theory · 2024Article
- "You rise up and then you start pulling people up with you": Patient experiences with a peer-delivered behavioral activation intervention to support methadone treatment.The International journal on drug policy · 2023Article
- A Psychometric Evaluation and a Framework Test of the HIV Stigma Mechanisms Scale Among a Population-Based Sample of Men and Women Living with HIV in Central Uganda.AIDS and behavior · 2023Article
- Trajectories of drug treatment and illicit opioid use in the AIDS Linked to the IntraVenous Experience cohort, 2014-2019.The International journal on drug policy · 2023Article
- Psychosocial challenges affecting patient-defined medication for opioid use disorder treatment outcomes in a low-income, underserved population: Application of the social-ecological framework.Journal of substance use and addiction treatment · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND
aimExperience of stigma towards methadone maintenance treatment (MMT) may be a barrier to the use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct and criterion validity of a theory-based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS) and compared this with the Substance Use Stigma Mechanism Scale (SU-SMS).
designSurveys at the beginning and end of a prospective study together with records of drug use and treatment attendance during that study.
settingCommunity methadone clinic in the Northeastern USA.
participantsNinety-three participants who were receiving MMT; the average daily methadone dose was 84.8 mg/day (standard deviation = 28.39 mg/day). MEASUREMENTS: The MMT-SMS uses a self-report questionnaire to assess three dimensions reflecting experiences of anticipated (nine items), enacted (nine items) and internalized stigma (seven items) specifically related to receiving MMT. Anticipated and enacted scales include three stigma source subscales (family, employers, health care workers; three items each). Responses are recorded on a five-point Likert-type scale, then averaged to produce the MMT-SMS scale/subscale scores. The SU-SMS is a self-report questionnaire to assess experiences of anticipated, enacted and internalized stigma regarding substance use history. Both scales were administered at the final parent study visit. Other measures included were assessed in the parent study and used to assess life-time and recent MMT (e.g. current MMT dose) and drug use experiences (e.g. past 30-day heroin injection).
findingsThe MMT-SMS demonstrated good internal reliability (α = 0.806-0.952 for components). Confirmatory factor analysis supported the seven-factor scale structure, distinguishing between experiences of anticipated, enacted and internalized stigma, and anticipated and enacted stigma source subscales (family, employers, health care workers) [root mean square error of approximation (RMSEA) = 0.076, 90% confidence interval (CI) = 0.061-0.090, P-close = 0.003; confirmatory fit index (CFI) = 0.974; Tucker-Lewis index (TLI) = 0.971]. Construct validity helped to distinguish the MMT-SMS from established substance use stigma constructs. Criterion validity observed associations with substance use experiences while on MMT, likely to predict future MMT success. Internalized MMT stigma was uniquely associated with daily MMT dose. Regarding criterion validity: anticipated MMT and enacted substance use stigma were associated with past 30-day heroin injection, MMT stigma uniquely associated with opioid use behaviors while receiving MMT, and substance use stigma broadly associated with injection-related behaviors.
conclusionsThe Methadone Maintenance Treatment Stigma Mechanisms Scale appears to be a reliable measure of methadone maintenance treatment stigma with robust validity in a sample of people with opioid use disorders receiving methadone maintenance treatment.
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