Stigma is a well-documented barrier to effective individual and community response to mental illness and, in recent years, is a recognized impediment to prevention and treatment of substance use disorders (SUDs). This study uses focus group data to explore stigmatizing views of medication assisted recovery (MAR) among those in recovery and the people, organizations, and communities that surround them, with attention to implications for long-term recovery. Across groups, we find consistent themes that MAR simply trades one drug for another, MAR should be used only as a stepping-stone to full abstinence, and that long-term use of MAR indicates ineffectiveness or treatment failure. Data suggest the prevalence of these perceptions leads those in recovery and providers to see MAR as a last resort treatment, encourages individuals to discontinue MAR before they are ready, and as result increases risk of relapse and overdose.