3:30pm - 3:45pm (CDT) | 4212.0 - “We both use dope. So what makes me better than them?” A qualitative inquiry into substance use and stigmatization.

Session: Integrated Behavioral Health: Voices of Stigmatized Populations

Program: Alcohol, Tobacco, and Other Drugs

Presenter: Kaylia Carroll, MPH

Authors:

Cathy Jian

Carmen Muniz-Almaguer

Carson F. Ferrara

Trace S. Kershaw, PhD

Abstract

Objectives

To identify participant experiences with stigmatization while in treatment for substance use and their strategies for coping and managing these experiences. To identify the circumstances in which individuals feel stigmatized due to their current or former status as someone who uses substances as well as coping methods they use to manage feelings of stigmatization.

Methods

We conducted semi-structured interviews with individuals in treatment for substance use in Connecticut and Georgia (n=56) about experiences with stigmatization, and differences in stigmatization by specific substances and modality of substance use (i.e. injection vs non-injection vs solely alcohol use. Themes were analyzed using The Health Stigma and Discrimination Framework.

Results

Five preliminary themes were identified:

1. Substance-specific and modality stigmatization; participants identified increased stigmatization for criminalized substances and substances used intravenously, compared to non-criminalized substances and non-injection modalities.
2. Rejection of stereotypes; participants had empathetic perceptions of substance use while acknowledging stigmatizing practices from peers in treatment environments.
3. Religion/spirituality coping strategies; participants identified religious/spiritual practices as a method of managing feelings of being stigmatized.
4. Familial and healthcare stigma; participants described stigmatization from healthcare practitioners and family.
5. Recovery-sensitive care; participants favored treatment providers with lived experience using substances to minimize their experience of stigmatization.

Conclusion

Programs are needed that minimize stigmatization that exists within treatment and healthcare contexts, including stigma from providers, families, and fellow individuals who use substances. Recommendations include prioritizing treatment providers who have personal experience with substance use.