CCARE Anti-Stigma Campaign

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Structural Stigma and How Professionals Can Change Stigma for a Person with a Substance Use Disorder (SUD)

Stigma can affect everyone - our members and their families, treatment professionals, and community activists. Stigma refers to negative opinions of an individual or group based on having certain characteristics. Stigma may result in an individual feeling shame or despair and experiencing discrimination. The person who experiences stigma about substance use may be less likely to feel comfortable seeking treatment.

Structural stigma refers to policies, protocols, and funding models that can perpetuate stigma, such as inequality in access to treatment (e.g., Black/African Americans or Hispanic, non-white Americans are less likely to be offered buprenorphine for OUD treatment than white non-Hispanic clients; Lagisetty et al., 2019).

The impact of stigma on people with an SUD has evolved over several decades, penetrates all levels of society, and is difficult to overcome (Krawcyzk et al., 2018; Park et al., 2020).

Things you can do as a provider to help eliminate stigma include:

  • Encourage equality between physical and behavioral health treatment.
  • Show compassion for those with substance use disorder.
  • Choose empowerment over shame.
  • Be honest about treatment.
  • Let others know when they’re being stigmatizing.
  • Avoid labeling people.
  • Promote non-judgmental, non-shaming inducting approaches.
  • Offer treatment in non-traditional ways, (e.g., offering treatment in places people of color and ethnic groups trust by partnering with churches, Hispanic Centers, or other community organizations).

Community Care is committed to reducing stigma for substance use disorders and everyone must work to lessen stigma. Consider your language to start. Even unknowingly, things we say may reinforce negative stereotypes and attitudes. Consider Community Care’s Anti-stigma Resources and Education (CCARE) as a starting point.

Lagisetty PA, Ross R, Bohnert A, Clay M, Maust DT. Buprenorphine Treatment Divide by Race/Ethnicity and Payment. JAMA Psychiatry. 2019 May 8;76(9):979–81. doi: 10.1001/jamapsychiatry.2019.0876. Epub ahead of print. PMID: 31066881; PMCID: PMC6506898

Krawczyk N, Negron T, Nieto M, Agus D, Fingerhood MI. Overcoming medication stigma in peer recovery: A new paradigm. Subst Abus. 2018;39(4):404-409. doi:10.1080/08897077.2018.1439798.

Park JN, Rouhani S, Beletsky L, Vincent L, Saloner B, Sherman SG. Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework. Milbank Q. 2020;98(3):700-746. doi:10.1111/1468-0009.12470.