Kelly Bourdet on the affluence gap between addicts on maintenance regimens (as opposed to, right, that scene from Trainspotting) who can get Suboxone ("bupe") in the privacy of their doctor's office, and lower income or uninsured addicts who are stuck with methadone and the associated hoops:
The disease model of addiction is widely perceived as resulting in a decrease in stigma. (It could be argued that popular culture's obsession with celebrity—and their high rates of substance abuse—has done more.) Yet the stigma persists, especially for people who live on the margins because of the color of their skin or the size of their income—those who stand in line at the nation's methadone clinics. While no less an "addict," a person who is on Suboxone can, if desired, entirely skirt the stigma by keeping their disease private, even a secret, including no public acknowledgement at a clinic or a 12-step meeting. As Tom points out, bupe is white-collar maintenance; methadone is for everybody else.
As Bourdet points out, there ARE benefits to the clinic approach; addicts who receive bupe are substantially less likely to attend substance abuse counseling sessions than those who receive methadone, for whom it is generally mandatory.