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Chapter 1 - Understanding the Stigma of Substance Use Disorders

Published online by Cambridge University Press:  23 June 2022

Georg Schomerus
Affiliation:
Universität Leipzig
Patrick William Corrigan
Affiliation:
Illinois Institute of Technology
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Summary

Substance use disorders (SUD) are among the most stigmatized mental health conditions. We explore the social function of SUD stigma, to demarcate the boundaries of acceptable behavior, and summarize how public stigma, self-stigma, and structural stigma increase harm due to SUD by delaying help-seeking, impairing treatment, criminalizing substance users, and reducing the life chances of people with SUD. We identify a continuum model of SUD, and a balanced view of social and individual responsibility, as potential areas where conceptual changes could decrease stigma. Contact-based interventions, education, and protest are strategies to overcome the stigma of SUD. Addressing the stigma of SUD will help to create a culture of hope, empowerment, and compassion, as well as high quality, stigma-free care for people with SUD.

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Publisher: Cambridge University Press
Print publication year: 2022

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References

Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2–3), 188196. https://doi.org/10.1016/j.drugalcdep.2006.10.014Google Scholar
Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146151. https://doi.org/10.1192/bjp.bp.112.122978Google Scholar
Canaway, R., & Merkes, M. (2010). Barriers to comorbidity service delivery: The complexities of dual diagnosis and the need to agree on terminology and conceptual frameworks. Australian Health Review, 34(3), 262268. https://doi.org/10.1071/AH08723Google Scholar
Cooper, H. L. (2015). War on drugs policing and police brutality. Substance Use & Misuse, 50(8–9), 11881194. https://doi.org/10.3109/10826084.2015.1007669Google Scholar
Cooper, H., Moore, L., Gruskin, S., & Krieger, N. (2005). The impact of a police drug crackdown on drug injectors’ ability to practice harm reduction: A qualitative study. Social Science & Medicine, 61(3), 673684. https://doi.org/10.1016/j.socscimed.2004.12.030Google Scholar
Corrigan, P. W. (2011). Best practices: Strategic stigma change (SSC): Five principles for social marketing campaigns to reduce stigma. Psychiatric Services, 62(8), 824826. https://doi.org/10.1176/ps.62.8.pss6208_0824CrossRefGoogle ScholarPubMed
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 3770. https://doi.org/10.1177/1529100614531398Google Scholar
Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765776. https://doi.org/10.1037//0003-066x.54.9.765CrossRefGoogle ScholarPubMed
Corrigan, P. W., Rafacz, J., & Rüsch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189(3), 339343. https://doi.org/10.1016/j.psychres.2011.05.024Google Scholar
Corrigan, P. W., Schomerus, G., Shuman, V., et al. (2017). Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the mental health stigma literature. The American Journal on Addictions, 26(1), 5966. https://doi.org/10.1111/ajad.12458Google Scholar
Corrigan, P. W., Watson, A. C., & Miller, F. E. (2006). Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members. Journal of Family Psychology, 20(2), 239246. https://doi.org/10.1037/0893-3200.20.2.239Google Scholar
Earnshaw, V. A., Bogart, L. M., Menino, D. D., et al. (2019). Disclosure, stigma, and social support among young people receiving treatment for substance use disorders and their caregivers: A qualitative analysis. International Journal of Mental Health and Addiction, 17(6), 15351549. https://doi.org/10.1007/s11469-018-9930-8Google Scholar
Foran, H. M., & O’Leary, K. D. (2008). Alcohol and intimate partner violence: A meta-analytic review. Clinical Psychology Review, 28(7), 12221234. https://doi.org/10.1016/j.cpr.2008.05.001CrossRefGoogle ScholarPubMed
Glass, J. E., Mowbray, O. P., Link, B. G., Kristjansson, S. D., & Bucholz, K. K. (2013). Alcohol stigma and persistence of alcohol and other psychiatric disorders: A modified labeling theory approach. Drug and Alcohol Dependence, 133(2), 685692. https://doi.org/10.1016/j.drugalcdep.2013.08.016Google Scholar
Goodyear, K., Haass-Koffler, C. L., & Chavanne, D. (2018). Opioid use and stigma: The role of gender, language and precipitating events. Drug and Alcohol Dependence, 185, 339346. https://doi.org/10.1016/j.drugalcdep.2017.12.037Google Scholar
Hasin, D. S. (2018). US epidemiology of cannabis use and associated problems. Neuropsychopharmacology, 43(1), 195212. https://doi.org/10.1038/npp.2017.198Google Scholar
Hasin, D. S., O’Brien, C. P., Auriacombe, M., et al. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry, 170(8), 834851. https://doi.org/10.1176/appi.ajp.2013.12060782Google Scholar
Heinz, A., Kiefer, F., Smolka, M. N., et al. (2020). Addiction Research Consortium: Losing and regaining control over drug intake (ReCoDe): From trajectories to mechanisms and interventions. Addiction Biology, 25(2), e12866. https://doi.org/10.1111/adb.12866CrossRefGoogle Scholar
Howard, M., McMillen, C., Nower, L., Elze, D., Edmond, T., & Bricout, J. (2002). Denial in addiction: Toward an integrated stage and process model – qualitative findings. Journal of Psychoactive Drugs, 34(4), 371382. https://doi.org/10.1080/02791072.2002.10399978Google Scholar
Khoramdad, M., Vahedian‐azimi, A., Karimi, L., Rahimi‐Bashar, F., Amini, H., & Sahebkar, A. (2020). Association between passive smoking and cardiovascular disease: A systematic review and meta‐analysis. IUBMB Life, 72(4), 677686. https://doi.org/10.1002/iub.2207CrossRefGoogle ScholarPubMed
Kilian, C., Manthey, J., Carr, S., et al. (2021). Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcoholism: Clinical and Experimental Research, 45(5), 899911. https://doi.org/10.1111/acer.14598Google Scholar
Kummetat, J. L., Leonhard, A., Manthey, J., Speerforck, S., & Schomerus, G. (2022). Understanding the association of public alcohol stigma and alcohol consumption within Europe. [Manuscript submitted].Google Scholar
Link, B. G., Angermeyer, M. C., Phelan, J. C., et al. (2011). Public attitudes towards people with mental illness. In Thornicroft, G., Szmukler, G., Mueser, K. T., & Drake, R. E. (Eds.), Oxford textbook of community mental health (pp. 253259). Oxford University Press. https://doi.org/10.1093/med/9780199565498.003.0137Google Scholar
Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400423. https://doi.org/10.2307/2095613Google Scholar
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363385. https://doi.org/10.1146/annurev.soc.27.1.363Google Scholar
Link, B. G., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511541. https://doi.org/10.1093/oxfordjournals.schbul.a007098Google Scholar
Livingston, J. D. (2020). Structural stigma in health-care contexts for people with mental health and substance use issues: A literature review. Mental Health Commission of Canada.Google Scholar
Morris, J., Albery, I. P., Heather, N., & Moss, A. C. (2020). Continuum beliefs are associated with higher problem recognition than binary beliefs among harmful drinkers without addiction experience. Addictive Behaviors, 105, 106292. https://doi.org/10.1016/j.addbeh.2020.106292Google Scholar
Paquette, C. E., Syvertsen, J. L., & Pollini, R. A. (2018). Stigma at every turn: Health services experiences among people who inject drugs. International Journal of Drug Policy, 57, 104110. https://doi.org/10.1016/j.drugpo.2018.04.004CrossRefGoogle ScholarPubMed
Peter, L. J., Schindler, S., Sander, C., et al. (2021). Continuum beliefs and mental illness stigma: A systematic review and meta-analysis of correlation and intervention studies. Psychological Medicine, 51(5), 716726. https://doi.org/10.1017/S0033291721000854Google Scholar
Phelan, J. C., Link, B. G., & Dovidio, J. F. (2008). Stigma and prejudice: One animal or two? Social Science & Medicine, 67(3), 358367. https://10.1016/j.socscimed.2008.03.022Google Scholar
Rehm, J., Marmet, S., Anderson, P., et al. (2013). Defining substance use disorders: Do we really need more than heavy use? Alcohol and Alcoholism, 48(6), 633640. https://doi.org/10.1093/alcalc/agt127Google Scholar
Rehm, J., & Shield, K. D. (2021). Alcohol use and cancer in the European Union. European Addiction Research, 27(1), 18. https://doi.org/10.1159/000507017Google Scholar
Schmitt, M. T., Branscombe, N. R., Postmes, T., & Garcia, A. (2014). The consequences of perceived discrimination for psychological well-being: A meta-analytic review. Psychological Bulletin, 140(4), 921948. https://doi.org/10.1037/a0035754Google Scholar
Schomerus, G., Baumann, E., Sander, C., Speerforck, S., & Angermeyer, M. C. (2021). Some good news for psychiatry: Resource allocation preferences of the public during the COVID‐19 pandemic. World Psychiatry, 20(2), 301302. https://doi.org/10.1002/wps.20875Google Scholar
Schomerus, G., Corrigan, P. W., Klauer, T., Kuwert, P., Freyberger, H. J., & Lucht, M. (2011). Self-stigma in alcohol dependence: Consequences for drinking-refusal self-efficacy. Drug and Alcohol Dependence, 114(1), 1217. https://doi.org/10.1016/j.drugalcdep.2010.08.013Google Scholar
Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M. G., & Angermeyer, M. C. (2011). The stigma of alcohol dependence compared with other mental disorders: A review of population studies. Alcohol and Alcoholism, 46(2), 105112. https://doi.org/10.1093/alcalc/agq089Google Scholar
Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2013). Continuum beliefs and stigmatizing attitudes towards persons with schizophrenia, depression and alcohol dependence. Psychiatry Research, 209(3), 665669. https://doi.org/10.1016/j.psychres.2013.02.006Google Scholar
Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2014). Attitudes towards alcohol dependence and affected individuals: Persistence of negative stereotypes and illness beliefs between 1990 and 2011. European Addiction Research, 20(6), 293299. https://doi.org/10.1159/000362407Google Scholar
Sellman, D. (2010). The 10 most important things known about addiction. Addiction, 105(1), 613. https://doi.org/10.1111/j.1360-0443.2009.02673.xGoogle Scholar
Smith, L. R., Earnshaw, V. A., Copenhaver, M. M., & Cunningham, C. O. (2016). Substance use stigma: Reliability and validity of a theory-based scale for substance-using populations. Drug and Alcohol Dependence, 162, 3443. https://doi.org/10.1016/j.drugalcdep.2016.02.019Google Scholar
Stolzenburg, S., Freitag, S., Evans-Lacko, S., Muehlan, H., Schmidt, S., & Schomerus, G. (2017). The stigma of mental illness as a barrier to self labeling as having a mental illness. The Journal of Nervous and Mental Disease, 205(12), 903909. https://doi.org/10.1097/NMD.0000000000000756CrossRefGoogle ScholarPubMed
Stolzenburg, S., Tessmer, C., Corrigan, P. W., et al. (2018). Childhood trauma and self-stigma of alcohol dependence: Applying the progressive model of self-stigma. Stigma and Health, 3(4), 417423. https://doi.org/10.1037/sah0000112Google Scholar
Subramaniam, M., Abdin, E., Picco, L., et al. (2017). Continuum beliefs and stigmatising beliefs about mental illness: Results from an Asian community survey. BMJ Open, 7(4), e014993. https://doi.org/10.1136/bmjopen-2016-014993Google Scholar
Walsh, C., MacMillan, H. L., & Jamieson, E. (2003). The relationship between parental substance abuse and child maltreatment: Findings from the Ontario Health Supplement. Child Abuse & Neglect, 27(12), 14091425. https://doi.org/10.1016/j.chiabu.2003.07.002Google Scholar
Williamson, L. (2012). Destigmatizing alcohol dependence: The requirement for an ethical (not only medical) remedy. American Journal of Public Health, 102(5), e5e8. https://doi.org/10.2105/AJPH.2011.300629Google Scholar
World Health Organization. (2016). The health and social effects of nonmedical cannabis use. World Health Organization. www.who.int/substance_abuse/publications/msbcannabis.pdfGoogle Scholar

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