As a fundamental cause of health inequities, stigma leads to the development of substance use disorders (SUDs), undermines SUD treatment efforts, and drives persistent disparities within these crises. Given their expertise in mental and behavioral health, psychologists are uniquely positioned to play a frontline role in addressing SUD stigma.
What factors influence stigma?
· The stigma against people with substance use disorders is a set of negative attitudes and stereotypes that can create barriers to treatment and make these conditions worse. 1 Although substance use disorders are chronic, treatable medical conditions, studies show people who have them often face stigma and discrimination in part because others do not …
How to overcome the stigma of addiction?
As a fundamental cause of health inequities, stigma leads to the development of substance use disorders (SUDs), undermines SUD treatment efforts, and drives persistent disparities within these crises. Given their expertise in mental and behavioral health, psychologists are uniquely positioned to play a frontline role in addressing SUD stigma.
What are the effects of stigma and discrimination?
Stigmatizing attitudes towards substance abusers include perceiving them as dangerous, unpredictable, unable to make decisions, to blame for their own conditions, and a willingness to coerce treatment and maintain social distance. Evidence-based programs that can reduce societal-level stigma towards those with substance use disorders are needed.
Is stigma a mental illness?
Addiction is a treatable disease. Addiction is a disease, not a character flaw. People suffering from substance use disorders have trouble controlling their drug use even though they know drugs are harmful. Overcoming a substance use disorder is not as simple as resisting the temptation to take drugs through willpower alone.
How can stigma affect people's willingness to seek treatment?
Consequences of Stigma This fear of being “found out” causes people to avoid seeking treatment, fail to take medications, isolate, and lose self-esteem. Studies show prejudice and discrimination against those who are mentally ill is pervasive and often as debilitating as the illness itself.
How does stigma affect drug abuse?
Ultimately, the stigma surrounding addiction can lead to guilt and shame, causing people to hide their addiction and prevent them from getting the treatment they need.
How does stigma affect recovery?
Stigma can negatively impact someone's mental health, self-image, and self-confidence. It can make someone feel depressed and lead to the denial of opportunities. These aspects of a person's psychology are vital for them to recover from a substance abuse disorder.
How does stigma affect people with Sud?
People with SUD are often viewed as unpredictable, dangerous, and morally responsible for their condition (2). These prejudiced and discriminatory views of the community may lead to reduced access to care, inability to make decisions regarding treatment, and forced or coerced treatment (2).
What are the effects of stigma?
The harmful effects of stigma feelings of shame, hopelessness and isolation. reluctance to ask for help or to get treatment. lack of understanding by family, friends or others. fewer opportunities for employment or social interaction.
How does stigma affect mental health?
Stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment. A recent extensive review of research found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illnesses.
What is recovery stigma?
While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination.
How can we reduce discrimination and stigma?
Seven Things You Can Do to Reduce StigmaKnow the facts. Educate yourself about mental illness including substance use disorders.Be aware of your attitudes and behaviour. ... Choose your words carefully. ... Educate others. ... Focus on the positive. ... Support people. ... Include everyone.
What are the effects of stigma and discrimination?
Stigma and discrimination can also make someone's mental health problems worse, and delay or stop them getting help. Social isolation, poor housing, unemployment and poverty are all linked to mental ill health. So stigma and discrimination can trap people in a cycle of illness.
What factors influence stigma?
FACTORS THAT INFLUENCE STIGMABlame. ... Stereotypes of Dangerousness and Unpredictability. ... Knowledge about Mental and Substance Use Disorders. ... Contact and Experience. ... Media Portrayals. ... Race, Ethnicity, and Culture.
What are some examples of stigma?
When someone with a mental illness is called 'dangerous', 'crazy' or 'incompetent' rather than unwell, it is an example of a stigma. It's also stigma when a person with mental illness is mocked or called weak for seeking help. Stigma often involves inaccurate stereotypes.
How to help people with substance use disorders?
It’s important to keep in mind that everyone can all do a better job of eliminating stigma around drug use. Educational programs and modeling of non-stigmatizing behavior can help people provide nonjudgmental, empathic support.
How does substance use disorder improve health care?
The primary care settings have been identified as untapped opportunities to engage individuals with substance use disorders and to offer evidence-based addiction treatment. The Surgeon General believes integrating substance use disorder in the mainstream health care will improve the quality of treatment services, patient health and quality of life. Integrated treatment with comprehensive continuing care will dramatically reduce fatalities, address health disparities, reduce societal costs and allow recovery to be an achievable outcome. But because substance use treatment is separated from the mainstream health systems, health providers are inadequately prepared to address the substance misuse or related problems in a clinical setting resulting in incorrect diagnoses, inappropriate treatment plans, poor adherence to treatment plans by patients, and high rates of emergency department and hospital admissions.
When did substance use disorder treatment begin?
Historically, individuals with substance use disorders have received treatment only in “addiction treatment programs” that were designed in the 1960s to treat addictions as personality or character disorders or mitigated by incarceration. This separation of substance use disorder treatment from the rest of health care has contributed to the lack of understanding of the medical nature of these conditions, lack of awareness among affected individuals about a significant health problem, and slow adoption of scientifically supported treatments.
What is the Surgeon General's report on addiction?
Alarmed by the Opioid Epidemic death toll, the Surgeon General released two reports, Facing Addiction in America, The Surgeon General’s Report on Alcohol, Drugs and The Surgeon General’s Spotlight on Opioids.
How can we improve patient care?
To improve patient care, healthcare professionals must change their personal attitude towards substance use disorders and appraise the role stigma is playing in shaping their practices. The medical community needs to examine to understand any negative mindset involving substance use disorder treatment, and transform all unhealthy stigmas contributing to substandard care into one more beneficial and in alignment with how other chronic conditions are successfully treated in primary care. Healthcare needs understand the goals of substance use treatment and value them the same as the treatment goals for other chronic illnesses namely, to eliminate or reduce the primary symptoms (substance use), improve general health and function, and increase the motivation and skills of patients and their families to manage threats of relapse.
How can we address stigma of substance use disorder?
One reasonable hypothesis, then, is that if as a society, we can begin to address the stigma of substance use disorder, we can help increase rates of treatment seeking. Changing our language by dropping the term “abuser” and adopting terminology more consistent with a medical and public health approach may be one way to do this.
What is the degree of stigma?
Importantly, degree of stigma is related to the perceived cause of the condition (if perceived not to be someone’s fault, stigma is lower) and perceived control over the condition (if perceived not to be under someone’s control, stigma is lower). In a prior special issue of the Recovery Research Institute bulletin, ...
What does "abuse" mean in the recovery field?
The Recovery Research Institute “Addiction-ary” can help provide ideas on terms that are less stigmatizing.
Is abuse a body of literature?
Overall, these studies are part of a body of literature that is helping to spur change in how language is used in the field. Recently, the International Society of Addiction Journal Editors, based in large part on these studies, provided guidance strongly cautioning against use of the term “abuse”, and advocated instead for either substance use disorder (if substance use meets diagnostic thresholds) or several variations on substance use that may cause harm, such as hazardous substance use or harmful substance use.
Why do people use the term "abuser"?
Given the common use of the “abuser” term among clinicians, scientists, policy makers, and the general public, this term may be a part of the reason why individuals seek or remain in addiction treatment.
Is substance abuser a cognitive bias?
It may be that exposure to the term “substance abuser” elicits a more punitive implicit cognitive bias whereas the term “substance use disorder” elicits a more therapeutic attitude. Use of the “substance use disorder” term may be preferable as it may be less stigmatizing. Given the common use of the “abuser” term among clinicians, scientists, ...
Is there a difference between groups in the perception of the individual as a social threat?
There were no differences between groups in the perception of the individual as a social threat or whether or not the individual could not control his difficulties and would benefit from treatment. Overall, then, trained mental health clinicians are less vulnerable to language-influenced perceptions of individuals with substance-related problems than individuals outside the mental health field. They are not completely immune, however, from the role language plays in how we perceive individuals with health conditions – substance-related health conditions in this case.
Why do health providers carry a stigma towards people with drug dependencies?
When health providers carry a stigma towards people with drug dependencies, it can affect their willingness to assess or treat the patient for substance abuse, how they approach him or her, and it may prevent addicted individuals from seeking healthcare altogether .
How does stigma affect healthcare?
Perceived stigma in hospitals or doctors’ offices can discourage people from accessing needed healthcare services. Having a trusted primary care doctor is associated with maintaining well-being and a good quality of life. However, studies have found that some healthcare providers feel uncomfortable when working with people who are dependent on drugs. In a study of nurses’ attitudes towards patients, the majority of nurses held negative views about people who used drugs (Howard & Chung, 2000). In another study of nurses in the UK, most of the nurses had a stigma against injection drug users (Monks, Topping, & Newell, 2013). When health providers carry a stigma towards people with drug dependencies, it can affect their willingness to assess or treat the patient for substance abuse, how they approach him or her, and it may prevent addicted individuals from seeking healthcare altogether.
Why do people hide their drug use?
They are also more likely to be depressed and may hide their drug use from health care providers to avoid stigma and drug shaming. The mental health consequences of isolation can fuel even more drug use, leading to further isolation, and ultimately a vicious cycle that is hard to be break out of.
How does drug use affect society?
People who use drugs can feel pushed to the outskirts of society and may lose touch with their community and family and experience profound loneliness and isolation. When a person does not have social ties or a person to talk to, they are less likely to reach out for healthcare or treatment.
Why are interventions not supported by the public?
Due to widespread stigma about those who use drugs and who suffer from addiction, however, these interventions are not usually supported by the public and believed by some to facilitate and encourage drug use – despite evidence demonstrating that they actually decrease drug use (Logan & Marlatt, 2010).
How does stigma affect public perception?
Unfortunately, stigma can affect the public’s perception of evidence-based harm reduction strategies. Harm reduction refers to public health interventions like: Needle exchanges. Substitution therapies. Safe drug consumption rooms that are designed to decrease the risk associated with drug use (e.g., infected needles).
Can you become dependent on drugs?
Becoming dependent on drugs can happen to anyone. It’s important to keep in mind that we can all do a better job of decreasing stigma around drug use.
Why is stigma important in substance abuse?
Stigma can reduce willingness of policy-makers to allocate resources, reduce willingness of providers in non-specialty settings to screen for and address substance abuse problems , and may limit willingness of individuals with such problems to seek treatment. All of these factors may help explain why so few individuals with substance use disorders receive treatment. Public education that reduces stigma and provides information about treatment is needed.
What is a substance use disorder?
Substance use disorders (SUDs), or addiction, are complex disorders that affect brain function and behavior, are characterized by impaired functioning and considerable harm to the individuals with the disorders and to society as a whole. Although evidence-based treatments exist, a large gap exists between the number of those with this disorder and those who receive treatment [1-4]. To address this gap, the National Institute of Drug Abuse has recently identified understanding and decreasing the stigma of SUD as a major priority [5]. Mental illness stigma has been examined in a multitude of studies, and is linked with poorer psychological outcomes, symptoms, and social functioning [6]. While negative public attitudes (or public stigma) towards SUDs and substance problems have been identified in prior national surveys [7-9], the last review of this topic, published in 2011, focused only on alcohol [10].Updating knowledge about the public stigma associated with SUDs is urgent given the increasing prevalence of these disorders in the U.S. general population [1, 3, 4, 11], and the need to educate the public and policy makers who shape allocation of governmental resources [12, 13].
What is a substance use disorder?
Substance use disorder (SUD) occurs when a person’s use of drugs or alcohol results in health issues or problems in their work, school, or home life. 1 Education and awareness around the harm of using substances, along with the support of friends, parents, and caregivers, can help prevent SUD.
How many people have substance use disorder?
One in 14 Americans reports experiencing a substance use disorder. There is not one single driving factor that leads to addiction. Some people may use drugs to help cope with stress, trauma, or to help with mental health issues. Some may even develop opioid use disorder after misusing opioids they are prescribed by doctors. In any case, using drugs over time makes it easier to become addicted.
What is MAT treatment?
MAT can be an effective way to overcome addiction to opioids. 5 Behavioral therapy can be equally important as it helps people change their attitudes and behaviors related to drug use, helps prevent relapse, and keeps people in recovery longer.
What is the first course of treatment for opioid use disorder?
Opioid use disorder may require medication as the first course of treatment. Medications for opioid use disorder (MOUD) can help with cravings and withdrawal symptoms. 3 MOUD is effective in helping people overcome addiction, stay in recovery longer, and prevent relapse. 4
Is addiction a character flaw?
Addiction is a disease, not a character flaw. People suffering from substance use disorders have trouble controlling their drug use even though they know drugs are harmful.
How does the brain adapt to drug use?
The brain adapts to continued drug use by developing a tolerance, which means it takes more of a drug to feel the same result.
Can you relapse after not taking a drug?
Relapse may happen to people who use drugs and can happen even years after not taking the substance. More than anything, relapse may be a sign that more treatment or a different method is needed. A routine review of one’s treatment plan may be necessary to determine if another method could be more effective.
What is stigma in substance use?
A standard dictionary definition of stigma is a mark of disgrace connected to a situation or quality of a person. A person who experiences stigma is seen as less than others.
What is stigma in health care?
Stigma is generally based on assumptions or misconceptions. Stigma affects individuals with a substance use disorder, health care providers, treatments, research, policies, and society as a whole. Language is a combination of words and phrases that set cognitive scripts in motion ...
Why is MAT stigmatized?
However, a stigma surrounds medication assisted treatment (MAT) due to the beliefs that using medication to treat substance use disorder is just “trading one drug for another”. This stigma could be affecting treatment outcomes, or lack of, for those who could benefit from SUD treatment.
How does laden words affect people?
There is consistent evidence that using laden words affects how people react to individuals with a substance use disorder. Two studies by Kelly and his colleagues [ 2, 5] suggest that these labels matter. Referring to a person as a “substance abuser” versus a person with a “substance use disorder” resulted in subjects offering more punitive judgments and viewing the person’s substance use as willful misconduct. A more recent study [ 6] also suggested that levels of stigma predict more punitive policies and less public health or treatment oriented policies. “.
Is "abuse" the same as "asphyxiation"?
Interestingly according to these norms, the word “abuse” has the same emotional valence as the words “asphyxiation” and “HIV.”. The term “abuse” is also right between the words homicide and rape.
Why do words matter in the first language?
They convey meaning whether the effect is good or bad. We can use our words to help decrease stigma [ 3 ]. Person first language recognizes that people are first of all, people. They may have a substance use disorder, so the language becomes person with a subsistence use disorder. Use of the terms abuse, abuser, crazy, addict, dirty or clean describing a toxicology screen or the status of the person, committed suicide, war on drugs, drug habit, “just say no” exemplify a brief preview of how substance use stigma is perpetuated through language.
Is there progress in the term "insane asylum"?
However, there is still progress to be made. Progression is especially necessary in the substance use disorder and addiction realm.
What Problem Does This Study address?
How Was This Study conducted?
What Did This Study find?
- Participants felt, overall, that the “substance abuser” was: 1. a) less likely to benefit from treatment 2. b) more likely to benefit from punishment 3. c) more likely to be socially threatening 4. d) more likely to be blamed for their substance related difficulties and less likely that their problem was the result of an innate dysfunction over which they had no control 5. e) that they w…
Why Is This Study Important
- Contextualizing the Importance of This Work: (Kelly & Colleagues, 2010)
1. In contextualizing the importance of this work,another related study is important to mention, also by Kelly and colleagues. In that study, mental health clinicians (two thirds of whom had a doctoral level degree) were randomized to receive just one of two vignettes about an individual …
Next Steps
- There are several next possible steps related to research on stigma and substance use disorder, including but not limited to the following three areas: 1. First, researchers might investigate stigma related to other types of language that are considered common parlance in the world of addiction treatment and recovery, such as “addict” and “alcoholi...
Citations
- Kelly, J. F., Dow, S. J., & Westerhoff, C. (2010). Does our choice of substance-related terms influence perceptions of treatment need? An empirical investigation with two commonly used terms. Journal of Drug Issues, 40(4), 805-818. Kelly, J. F., & Westerhoff, C. M. (2010). Does it matter how we refer to individuals with substance-related conditions? A randomized study of tw…
Definition
Introduction
Society and culture
Prevention
Healthcare
Benefits
Access
Controversy
Effects
- Perceived stigma can cause major harm to people in their social lives. The chronic stress of discrimination may affect the mental and social health of individuals who use drugs. People who use drugs can feel pushed to the outskirts of society and may lose touch with their community and family and experience profound loneliness and isolation. When a...