'Allowing the right' and its currency in managing drug stigma in Greece

Relationship between anxiety and drug abstention motivation in men with substance use disorders: a cross-sectional study of compulsory isolation rehabilitation in China

Studies have found that anxiety is among the common negative emotions in individuals with substance use disorders. Anxiety affects drug abstention motivation, but the mechanism underlying this effect is still unclear. The current study aimed to examine the relationship among anxiety, regulatory emotional self-efficacy, psychological resilience and drug abstention motivation in an attempt to explore the mechanism underlying drug abstention motivation. The participants were 732 men with substance use disorders who were sent to compulsory rehabilitation in China. All participants completed measures of anxiety, regulatory emotional self-efficacy, psychological resilience and drug abstention motivation through questionnaires. The results indicated that anxiety negatively predicts drug abstention motivation. Regulatory emotional self-efficacy mediates the relationship between anxiety and drug abstention motivation. In addition, psychological resilience moderates the mediation between anxiety and regulatory emotional self-efficacy. The current results are not only helpful for understanding the relationship between anxiety and drug abstention motivation from the perspective of emotion but also of great significance for guiding individuals with substance use disorders in enhancing their drug abstention motivation by reducing negative emotion.

"I'm not like others": stigma navigation by people who inject drugs in Vietnam

Background

People who inject drugs are subjected to great stigmatization in many parts of the world. How they deal with stigma is closely linked to how stigma means to them. Understanding the strategies individuals employ to cope with these negative attitudes and what resources they mobilize in this process gives useful insights for clinical work and policy development.

Methods

We conducted 12 months of field observation in 2017 and 2018 and 54 in-depth interviews with people who inject drugs in Haiphong, Vietnam. Grounded theory underpinned our sampling and data analysis.

Results

The strategies participants used to manage stigma were both information and tension management. Many participants not only concealed their drug use but actively cultivated a pro-social image based on Vietnamese cultural virtues such as selflessness, hard work or harmonious living with others. Participants withdrew from social relationships to distance themselves from the stereotype of a money-begging drug user. They used techniques of neutralization to emphasize their good character and reframe their drug-related issues in a different light in order to negotiate their social status with their interlocutors.

Conclusion

People who inject drugs endorse the same social values and aspirations as nonusers. A good support structure and resources could help them to cope more effectively with stigma.

Compassion Fatigue and Compassion Satisfaction Among Addiction Nursing Care Providers in Greece: A Mixed Method Study Design

ABSTRACT

The risk of compassion fatigue (CF) for professionals who support and care for individuals and families facing the dual burden of addiction and trauma has been recently recognized. The aim of this mixed methods study was to investigate CF/secondary traumatic stress and compassion satisfaction (CS) in addiction nursing care providers. The Professional Quality of Life Scale was distributed to 21 addiction nurses and 29 nurse assistants in the alcohol and drug dependency centers of a psychiatric hospital in Greece. High CF risk was reported in 22% of participants, whereas 46% expressed high-to-moderate potential for CS. Participants described the long transition from compassion frustration or disengagement at the beginning of their career to CS at later stages. Learning to be compassionate entailed finding the right distance, redefining therapeutic role and expectations, and containing feelings and experiences. Being able to experience CS involved getting satisfaction from small changes, personal and professional growth, and self-care. A compassionate organizational culture, clinical supervision, and ongoing education may protect addiction professionals from absorbing or internalizing unmanageable emotions, which may lead to CF and also help them to gain a deeper understanding of their communication and interactions with individuals fighting addiction.

How to be self-reliant in a stigmatising context? Challenges facing people who inject drugs in Vietnam

BACKGROUND

Stigma works to reinforce dominant social values. The meaning of stigma is therefore not static but dependant on the regime in power. Taking into account the significant socioeconomic changes that took place in Vietnam over the last thirty years, this study explores the meaning of stigma directed at Vietnamese people who inject drugs in different social spheres.

METHODS

This qualitative study was conducted as part of an evaluation of a peer outreach program that distributes harm-reduction supplies and information, and provides treatment referral assistance to people who inject drugs in Haiphong, Vietnam. We conducted ethnographic field observations with peer outreach workers, home visits, and 54 in-depth interviews with participants in 2017 and 2018. Grounded theory led our theoretical sampling and analysis.

RESULTS

Stigma towards people who inject drugs seems to centre on the ability to be self-reliant rather than on drug-using behaviours. Participants described how their families and neighbours expressed expectations that they should manage their substance use issues by themselves, without considering the barriers they face in the job market. Participants interpret stigma directed at them in terms of poverty rather than drug use. As a result, they sometimes engage in illegal income-generating activities to pursue financial autonomy and to regain their social status.

CONCLUSION

People who inject drugs were struggling to conform to social expectations of self-reliance with limited support to realise it. Effective interventions must consider the many facets and challenges individuals encounter in their daily lives.

Rehabilitation From Addiction and Chronic Illnesses: A Comparative Analysis of the Narratives of Hungarian Patients

BACKGROUND

In Hungary the psychological care provided during the rehabilitation of patients with chronic illnesses is insufficient. Patients with addiction, on the other hand, appear to make more use of psychological services. Narratives of patients recovering from addiction and patients with various chronic illnesses were examined in order to gain a better understanding of psychological phenomena during rehabilitation.

METHODS

Semi-structured interviews were carried out. Narrative and thematic analysis was used in order to determine the structure and characteristics of patients' narratives.

RESULTS

The narratives of patients recovering from addiction were found to be more structured and uniform; they identified with their illness and played an active role in their recovery. Patients with a chronic illness mainly recounted passive events and physical difficulties. Stigmatization was mentioned by both groups.

IMPLICATIONS FOR PRACTICE

The level of stigmatization experienced by patients with a chronic illness may be one of the reasons why they use healthcare services more frequently than patients with an addiction. The authors believe that teaching patients to provide good narratives about suffering from and recovering from chronic illnesses may aid them in the rehabilitation process. An adaptive mixture of different illnesses and addiction narratives might be beneficial in the recovery process of various patient groups.

"Not human, dead already": Perceptions and experiences of drug-related stigma among opioid-using young adults from the former Soviet Union living in the U.S

BACKGROUND

Young people from the former Soviet Union (FSU) in the U.S. are engaging in opioid and injection drug use (IDU) in substantial numbers, paralleling nationwide trends. Yet opioid-using FSU immigrants face distinctive acculturation challenges, including perceived stigmatisation as drug users within their immigrant communities, which may exacerbate the negative health and psychosocial consequences of such use.

METHODS

This qualitative study draws on semi-structured interviews with 26 FSU immigrant young adults (ages 18-29) living in New York City who reported opioid use in the past month and/or were currently in treatment for opioid use disorder. Interviews probed youths' drug use histories, immigration/acculturation experiences, family and peer relationships, and service utilisation. Interviews or focus groups were also conducted with 12 FSU mothers of opioid-using youth and 20 service providers familiar with the FSU population. In a content-based thematic analysis, verbatim transcripts were coded for salient themes.

RESULTS

All three participant groups emphasized that stigma towards drug users within the FSU community is pervasive and acute, in contrast to the cultural acceptance of heavy drinking, and is rooted in punitive Soviet-era drug policies, fostering widespread ignorance about drugs and addiction. Young adults and service providers reported instances in which anticipation of community stigmatisation deterred youth from accessing drug treatment and harm reduction services. Similarly, stigma contributed to parents' failure to recognize early signs of their children's opioid problems and their reluctance to seek drug treatment for their children until opioid use had become severe. Young adults described how drug-use stigma is frequently internalized, leading to shame and loss of self-esteem.

CONCLUSION

Findings indicate an urgent need for community-wide education about drugs within FSU immigrant communities, and suggest specific service modalities that may be less stigmatizing for youth, such as peer-delivered syringe exchange and harm reduction education, and technology-based interventions that can be accessed privately and discreetly.