Background: Methadone maintenance treatment programs implemented in Aboriginal communities have proven to be beneficial for the control of opioid addiction and its associated consequences, but the perceptions and opinions of different community members about these programs remain elusive. The goal of this study was to determine the perceptions of members of a First Nation community in New Brunswick, Canada, on the implementation of a methadone maintenance treatment program and its effects on the community. Methods:We conducted a qualitative study using semistructured focus group discussions with 3 distinct groups composed of health care professionals and influential community members, patients in the methadone maintenance treatment program and community members at large. Thematic analysis of discussion transcripts was performed.Results: A total of 22 partipants were included in the 3 focus groups. All groups of participants expressed that patients in the program are stigmatized and marginalized. Discussions also revealed widespread misconceptions about the program. Participants associated the program with improvements in community-level outcomes and in parenting abilities of patients, but also with difficulties preserving family unity.Interpretation: Despite being culturally adapted to the community, elements surrounding the methadone maintenance treatment program in this First Nation community appear to be misunderstood and stigmatized. It may be beneficial to provide community education on these programs to assure community buy-in for the successful implementation of harm reduction programs in Aboriginal communities. Abstract Research Research CMAJ OPEN E432CMAJ OPEN, 4(3)non-Aboriginal participants. [17][18][19] A report from the Health Council of Canada highlighted the importance of considering and respecting culture in Aboriginal health care to offer "culturally competent care" in "culturally safe environments." 20Although this applied to harm reduction strategies, it was suggested that the implementation of methadone maintenance treatment programs within Aboriginal communities can be accompanied by apprehension and distrust.21 Thus, although individual-level benefits of methadone programs have been established, knowledge on the perceptions and opinions of Aboriginal communities on these programs remains elusive.The First Nation reserve of Elsipogtog (population 3272) is located in southeastern New Brunswick, Canada. The Elsipogtog methadone maintenance treatment program was started at the Elsipogtog Health & Wellness Centre in 2007 to help counter the community's high rates of substance abuse and its related consequences. The program's mission is true to First Nation cultural beliefs and provides care according to the native medicine wheel. Most of the program's staff are from the Elsipogtog community and provide services in Mi'kmaq. They include a family physician, a nurse practitioner, a registered nurse, an alcohol-drug counsellor and a psychologist, as well as a traditional elder and a medical receptio...

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