Reduce Stigma

Return to Opioid Top-Level Strategy Map or ZOOM MAP - Improve Treatment & Enable Recovery of People with SUDs

Background

Recent research showed that substance use is more stigmatized than obesity and smoking tobacco.

Self-stigma: Shame, evaluative thoughts, and fear of enacted stigma -- prevents users from seeking prevention services, testing and treatment. Stigma also limits employment, school enrollment, housing and access to social and safety net services for users.

 Studies have shown that people with substance use disorder experience labeling, shame, and rejection from family members, friends, teachers, co-workers, supervisors, and health care professionals. This stigma can get in the way of the support that people in recovery --and early recovery especially -- need. Outside stigma can become internalized, leading people in recovery to embody and adopt inaccurate beliefs about themselves due to their exposure to external stigmatizing forces.

 

 

Current Status

A 2014 literature review of programs for reducing stigma found that online education programs and face-to-face education programs were equally effective in reducing personal stigma (an individual's own attitude towards people with mental illness), but neither was effective in reducing self-stigma. Other research has shown that therapeutic interventions such as group-based Acceptance and Commitment Therapy (ACT) and vocational counseling produce positive outcomes for substance users suffering from self-stigma.

Some suggestions for stigma-reducing language:

• Call it what it is: substance use disorder (or alcohol use disorder, cocaine use disorder, etc.) or substance dependence (or alcohol dependence, drug dependence, etc.). In a non-clinical environment, addiction is also acceptable.
• Use "people first" language and refer to people with substance use disorder, people with drug dependence, people with addiction.
  • The new edition of the Associated Press style book recommends people first phrasing with the goal of separating the person from the disease.
• Avoid negative terms like addict, junkie, wino, boozer, drug fiend, and bum.

 

Social Factors & Participation in Treatment Programs

Individual and Social Factors Associated With Participation in Treatment Programs for Drug Users
Research conducted by: V. Anna Gyarmathy and Carl A. Latkin

The purpose of the research project was to establish a clear connection between the effect of positive social influence and the number of recovering addicts seeking treatment. The research team worked
to identify factors that impede or facilitate treatment participation. Based on this analysis, they concluded that social influence may not only promote entry into treatment but also the success of treatment results.

Click here to read academic article.

Stigma Around Addiction Treatment

Due to a high volume of treatment centers more focused on profit than patients, a certain stigma has developed around seeking treatment. Certain practices, however, can be seen as red flags for these unscrupulous treatment centers. Educate users seeking treatment as well as people who do patient referrals about these signs to avoid sending patients to these types of treatment centers.
Causes of Addiction Treatment Stigma

• The High Number of Arrests for Drug Possession in the United States
• Patient Brokering
  • This illegal practice occurs when "body brokers" make money by recruiting addicts for unethical and unscrupulous treatment facilities
• Rampant Urinalysis Testing and Lab Abuse
  • Some sober homes around the country have found a way to make money by recruiting people for the intensive outpatient programs (IOPs) that take place at drug rehab centers. These centers charge millions of dollars in fees to insurance companies for drug urinalysis performed on patients in IOPs.
• Unbranded Drug Rehab Websites
  • Some facilities have created unbranded websites to attract additional web traffic. These websites often try to appear like an independent source verifying that one rehab center may be better than another, when in reality that website was created by a rehab center.
• Lack of Outcomes Data
  • The measure of substance use disorder treatment effectiveness may be more nuanced than presented by the treatment center's website. For example, if a center says it has a 90% success rate, that most likely refers to the following conditions
    • A reduction in the frequency of substance use during drug rehab treatment
    • A reduction in the amount of the substance being used during drug rehab treatment
    • Successful sobriety for a relative period of time (i.e. self-reported sobriety among patients between 3 and 6 months after treatment)
• Drug Rehab Centers: Some Claim to Be Experts at Everything

 

Use Person-Centric Language

 

Those writing about mental health and addiction should strongly consider the language they use when describing those struggling with those issues. People-first language or person-centric language can influence whether the material produced is further stigmatizing to people. See Tools & Resources for a guide to using person centric language.

 

 

Tools & Resources

TR - Reduce Stigma of Seeking Help for Substance Misuse

Scorecard Building

Potential Objective Details
Potential Measures and Data Sources
Potential Actions and Partners

Resources to Investigate

More RTI on Stigma and Substance Misuse

PAGE MANAGER: [insert name here]
SUBJECT MATTER EXPERT: [fill out table below]

Reviewer	Date	Comments

 

Sources

 

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1. Substance use more stigmatized than smoking and obesity
   Lindsay A. Phillips and Autherine Shaw
   Journal Of Substance Use Vol. 18 , Iss. 4,2013[1]
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Griffiths, Kathleen M et al. “Effectiveness of Programs for Reducing the Stigma Associated with Mental Disorders. A Meta-Analysis of Randomized Controlled Trials.” World Psychiatry 13.2 (2014): 161–175. PMC. Web. 13 Jan. 2017.
[5]

• Livingston, James D et al. “The Effectiveness of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review.” Addiction (Abingdon, England) 107.1 (2012): 39–50. PMC. Web. 10 Jan. 2017.
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