Substance Use Disorder – Break the Stigma!
- Category: News
- Posted On:
Jeff Kukel, Pharm D.
Pharmacy Manager, AGHRx RediScripts
Atlantic General Hospital
Substance Use Disorder – Break the Stigma!
Substance Use Disorder (SUD), a treatable mental health condition, occurs when the recurrent use of alcohol and/or drugs causes problems in a person’s home, work, or school life. The U.S. loses nearly 185 people every day to substance overdose deaths. Opioids are involved in almost 70% of the lives lost due to substance overdoses, equating to nearly 47,000 opioid-related deaths in 2018 alone. Opioid Use Disorder (OUD) is a type of SUD defined by the repeated use of opioids. The economic burden of OUD and fatal opioid overdose is estimated to be over one billion dollars annually in the U.S. OUD significantly impacts the lives of individuals who experience OUD, families and loved ones, and communities nationwide.
SUDs, including OUD, are among the most stigmatized health conditions in the U.S., despite the many evidence-based treatment options. Stigma around opioid use disorder creates many challenges including barriers for people to seek treatment and access care as well as reduced employment or educational opportunities and marital or social problems.
To better identify, understand, and eliminate stigma, let’s explore how stigma against treatment hinders recovery, evidence-based treatments for OUD, and strategies to combat OUD treatment stigma.
Stigma against people with OUD increases the harm experienced, creating a negative cycle that may impact an individual’s recovery journey.
Stigma is defined as negative beliefs about, and attitudes toward a specific group of people. Stigma is being “reduced…from a whole and usual person to a tainted, discounted one.” Stigma manifests in multiple ways such as public, structural, and self-stigma, all of which create barriers to obtaining treatment, and ultimately results in only 10% of people with a SUD receiving treatment. The pathway to treatment looks different for everyone is very different and must be individualized.
Public stigma is the negative views held by society about a group of people. It labels that group as “other” and views them as flawed and lesser. OUD as a medical illness is still overshadowed by its misconception as a moral weakness or a willful choice
Structural Stigma is the collection of negative views held by a society that leads to practices and policies that discriminate against the stigmatized group.
Self-stigma occurs when a person adopts and internalizes the public stigma held by the society around them and begins to view and label themselves in the same way that society does.
All stigma creates barriers between people with OUD and treatment. People with OUD may avoid seeking out treatment for their disorder to avoid being labeled and stigmatized. Structural and public stigma decrease public support for funding substance use treatment services, thus making services less available to those in need. Public stigma may also prevent treatment facilities from being built within communities, making it difficult for people to find local treatment options. Public stigma may even impact the quality of health care a person receives. OUD stigma ultimately leads to fewer people being able to find, enter, and successfully complete treatment.
Learning about effective treatments for OUD is an effective way to reduce the stigma against OUD. Successful treatment looks different for everyone and there are a number of effective treatment options available. Treatment should begin with a clinical assessment to establish a plan best suited for each individual. The most effective treatments combine medication-assisted treatment (MAT) for OUD with psychosocial and/or behavioral treatments. A few examples of evidence-based treatments for OUD are:
Psychosocial treatments: Used to help people learn to control desire for substances and avoid using substances while also teaching healthy coping skills for stressors or emotions.
Behavioral treatments: A specific type of psychosocial treatment that focus on the current problems a person faces, rather than past events, by supporting people through setting and achieving specific goals related to OUD.
The recovery process is facilitated by the help of supportive relationships. Here are some ways that you can combat stigma in your own life and help support people in recovery:
- Recognize that OUD is treatable and recovery is possible!
- Learn more about evidence-based treatment strategies for OUD.
- Support loved ones and encourage treatment.
- Read or listen to stories from the opioid crisis, spread hope and healing.
- Acknowledge and understand the contributing factors for OUD.
- Replace stigmatizing terms with person-first language (e.g., a person with substance use disorder vs. addict, a person in recovery vs. getting clean)
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