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Chegeni R, Sagoe D, Syvertsen A, Erevik EK, Haghish EF, Pallesen S. Some for a Good Time, Some for a Long Time: Women's Ratings of the Mate Value of Men with Different Addictions - An Experimental Study. Subst Use Misuse 2024:1-7. [PMID: 39323067 DOI: 10.1080/10826084.2024.2403107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
Background: The present study aimed to explore women's perception of men with different addictions in terms of their short- and long-term mate value. Objectives: 2,525 women (age range: 18-40, M = 28.35, SD = 6.39) were randomized to six conditions in a vignette-based experiment where a male of otherwise high mating value was described as suffering from either gambling, gaming, cannabis, anabolic androgenic steroid, and alcohol addiction or as not suffering from addiction (control). Results: Regarding long-term mate value of the target, the control target was rated higher than each of the targets. The gaming target was rated higher than the alcohol, cannabis, and gambling targets. Finally, the AAS target was rated as higher on long-term mate value than the alcohol and gambling addiction targets. Conclusions: Overall, women seem to perceive risk-taking in the face of uncertainty, reflected by gambling addiction, as an attractive behavioral tendency in men in terms of short-term mating. In contrast, potential long-term mates with gaming or chemical addictions are viewed more negatively, probably because it signals inadequate time and resources to be invested in a relationship.
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Affiliation(s)
- Razieh Chegeni
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Norway
| | - André Syvertsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Norway
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Norway
| | - E F Haghish
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Norway
- Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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2
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Douglass CH, Win TM, Goutzamanis S, Lim MSC, Block K, Onsando G, Hellard M, Higgs P, Livingstone C, Horyniak D. Stigma Associated with Alcohol and Other Drug Use Among People from Migrant and Ethnic Minority Groups: Results from a Systematic Review of Qualitative Studies. J Immigr Minor Health 2023; 25:1402-1425. [PMID: 36976449 PMCID: PMC10632266 DOI: 10.1007/s10903-023-01468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
Stigma reduces access to alcohol and other drug (AOD) support. This systematic review explored perceptions and experiences of stigma associated with AOD use among migrant and ethnic minority groups. Qualitative studies published in English were identified using six databases. Two reviewers screened and critically appraised articles using the Joanna Briggs Institute Critical Appraisal Checklist for qualitative studies. Data were synthesised using best fit framework synthesis. Twenty-three studies were included. Stigma drivers and facilitators included stereotypes, socio-cultural norms, legal responses and precarious lived experiences. Stigma intersected with gender, citizenship, race and ethnicity and manifested though shame, exclusion, secondary stigma and discrimination in treatment. Outcomes and impacts included avoidance of services, emotional distress, isolation and loneliness. This review identified similar stigma experiences to other populations, however outcomes were complicated by precarious lived experiences and multiple stigmatised identities. Multi-level interventions are required to reduce AOD-related stigma for migrant and ethnic minority groups.
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Affiliation(s)
- Caitlin H Douglass
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Thin Mar Win
- Burnet Institute Myanmar, 226 Wizaya Plaza, U Wisara Road, Yangon, Myanmar
| | | | - Megan S C Lim
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Karen Block
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Gerald Onsando
- Melbourne School of Social and Political Sciences, University of Melbourne, 420 John Medley Building, Parkville, VIC, 3010, Australia
| | - Margaret Hellard
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peter Higgs
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Public Health Department, La Trobe University, Plenty Road, Bundoora, VIC, 3086, Australia
| | - Charles Livingstone
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danielle Horyniak
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Chavanne D, Ahluwalia JS, Goodyear K. The effects of race and class on community-level stigmatization of opioid use and policy preferences. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 120:104147. [PMID: 37639913 DOI: 10.1016/j.drugpo.2023.104147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND With opioid use and overdose rates continuing to plague minority communities in the U.S., we explored whether a geographic community's racial composition and social class affect how opioid use in the community is stigmatized and what policy preferences arise in response. METHODS We use case vignettes in a randomized, between-subjects study (N = 1478) with a nation-wide survey. The vignettes describe a community where opioids are harmfully used, varying whether the community was (1) wealthy or poor, (2) predominantly Black or White and (3) facing prevalent use of painkillers or heroin. We tested how these variables affect public stigmatization of opioid use (measured with ratings of responsibility, dangerousness, sympathy, concern, anger, and disappointment) preferred levels of social distance from communities with opioid use (measured with responses to questions about living, working, and interacting in the community), and policy preferences for responding to opioid use (measured with levels of support for providing a safe-consumption site in the community, treating drug use in the community punitively, treating drug use in the community as an illness, and funding drug treatment in the community through income redistribution). RESULTS Compared to wealthy communities with opioid use, poor communities with opioid use were less stigmatized in terms of responsibility, sympathy, concern, anger, and disappointment; they were also met with less support for punitiveness, more support for treating drug use as an illness, and preferences for greater social distance. Compared to White communities with opioid use, Black communities with opioid use were less stigmatized in terms of responsibility, and they were met with stronger preferences to not live and work there and with reduced support for using income redistribution to provide drug treatment for people in the community. Poor-Black communities with opioid use were also perceived to be more dangerous than both poor-White and wealthy-Black communities with opioid use. CONCLUSION These results point to class- and race-based territorial stigma affecting how communities with opioid use are judged and whether policies for providing communities with treatment are supported.
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Affiliation(s)
- David Chavanne
- Department of Economics, Connecticut College, New London, CT, USA.
| | - Jasjit S Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA; Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
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Akande AO, Riehman-Murphy C, Oji-Mmuo C, Jones AA, Chen Q, Segel JE, Sterner GE, Adam MT. A scoping review of the opioid epidemic among U.S. Immigrants: Implications for treatment practices. J Ethn Subst Abuse 2023:1-19. [PMID: 36752662 PMCID: PMC10411101 DOI: 10.1080/15332640.2023.2173346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The purpose of this review was to identify knowledge gaps within the literature regarding the impact of opioid use disorder, specific to immigrants in the United States, by addressing the following questions: 1) What is presented in the literature about the impact of opioid use disorder (OUD) and the opioid epidemic on immigrants in the United States?; and 2) What role does culture play in the opioid use disorder experiences of immigrants in the United States? Nineteen research articles were uncovered that addressed immigrants in the U.S. and opioid use disorder. The following themes prevailed: 1) OUD comparisons, 2) OUD comorbidities, 3) disparate OUD treatment engagement, and 4) the role of country of origin. Limited review findings support the need for future research on the topic of opioid misuse among immigrants in the United States. The authors elaborated on additional issues that influence OUD rates and warrant further exploration. Matters related to the potential positive roles of religion and faith leaders, cultural perceptions and expectations about gender roles, immigration status, ethnically diverse needs among sub-groups of immigrants, the role of geographic location within the U.S., and the implications of COVID-19 on OUD among immigrants need to be addressed to alleviate the deleterious impact of opioid misuse among immigrants.
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Affiliation(s)
| | | | | | | | - Qiushi Chen
- The Pennsylvania State University Libraries, Penn State Abington, Abington, Pennsylvania
| | - Joel E Segel
- Penn State College of Medicine, Hershey, Pennsylvania
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5
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Jessell L, Mateu-Gelabert P, Guarino H, Fong C. Why Young Women Who Use Opioids Are at Risk for Rape: The Impact of Social Vulnerabilities and Sexually Coercive Drug Using Contexts. Violence Against Women 2022:10778012221137921. [PMID: 36537102 DOI: 10.1177/10778012221137921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study tests a theoretically informed model to understand why women who use opioids (WWUO) are at risk of rape while using drugs. Structured interviews were conducted with 168 WWUO. Three domains were hypothesized to increase risk: the sexually coercive context of drug use, women's social vulnerability, and drug use severity. Logistic regression examined the odds of being raped by domain. One-third of WWUO had been raped while using drugs. The sexually coercive context and social vulnerability domains significantly increased women's odds of being raped. Prevention efforts should target social and contextual factors.
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Affiliation(s)
- Lauren Jessell
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Pedro Mateu-Gelabert
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Honoria Guarino
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Chunki Fong
- CUNY Graduate School of Public Health and Health Policy, Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
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Ali F, Russell C, Nafeh F, Chaufan C, Imtiaz S, Rehm J, Spafford A, Elton-Marshall T. Youth substance use service provider’s perspectives on use and service access in ontario: time to reframe the discourse. Subst Abuse Treat Prev Policy 2022; 17:9. [PMID: 35123527 PMCID: PMC8818169 DOI: 10.1186/s13011-022-00435-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/14/2022] Open
Abstract
Background Age is a critical factor in substance use and related outcomes, with adolescence being a particularly sensitive period. Early initiation of substance use has been linked with higher risk for developing substance use disorders. In Ontario, Canada, substance use is common among youth, yet treatment is underutilized, suggesting the potential for an unmet need in terms of substance use care. Despite these challenges, there is limited research examining factors that contribute to youth substance use and youth-specific barriers to substance use care. To fill this knowledge gap, this study sought to include the unique perspectives of service providers who work directly with youth to examine these issues. Methods We used a cross-sectional mixed-methods design to examine factors that contribute to substance use among youth and identify youth-specific barriers to substance use among a sample of 54 Ontario-based youth service providers. Data collection included an online survey completed by all study participants followed by qualitative interviews of a subsample of 16 participants. Data analysis included basic frequency tabulations for survey results and thematic qualitative analyses to identify common themes. Results Licit substances were identified as the most commonly used among youth, where 94% of respondents identified cannabis use and 81% identified alcohol use. Thematic analyses identified the role of dominant substance use discourses in normalizing certain substances (i.e., cannabis and alcohol) while also endorsing stigmatizing beliefs and sentiments. According to youth service providers, the intersection of these two discourses simultaneously lead to an increase in substance use while deterring youth from seeking substance use care. Conclusions Normalization and stigmatization are two dominant discourses around youth substance use, with important implications for public health interventions. Key public health strategies, as identified by participants, to reduce the overall negative effect of these factors include the need to reframe substance use discourse, from a moral failing to a public health issue and to educate youth about the impacts of use. To accomplish this goal educational campaigns to raise awareness around the health effects of use and address stigmatization are needed. Educational reforms are also needed to ensure that these programs are integrated into the school system.
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“Returning to Ordinary Citizenship”: A Qualitative Study of Chinese PWUD’s Self-Management Strategies and Disengagement Model of Identity. Behav Sci (Basel) 2022; 12:bs12080258. [PMID: 36004829 PMCID: PMC9404964 DOI: 10.3390/bs12080258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023] Open
Abstract
How PWUD (people who use drugs) live under drug governance is an important research question. This study adopts a qualitative research method to explore how PWUD in China self-manage after perceiving the dilemma of incomplete citizenship and the social pressure brought by drug control arrangements. Through analysis of 130 PWUD’s files and in-depth interviews with 10 interviewees (from the 24 preliminary interviews), this study found that PWUD developed action strategies of hidden mobility (spatial isolation), disconnection of past experiences (time isolation), instrumental actions, as well as narrative strategies of reframing themselves as ordinary citizens with attempts of reversing identity disadvantages. Further, PWUD’s self-management strategies manifest as a disengagement model in which the actors (PWUD, not rehabilitation agencies) do not intend to develop integrative positive identities through dispersed, practiced behavioral strategies, but attempt to return to pre-addiction, non-socially exclusionary citizenship experiences. The disengagement model and its negative effect on PWUD’s social integration help us reflect on the current implementation of rehabilitation projects and institutional settings of drug governance.
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8
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Zeng Y, Han L, Cheng Y, Jia CX. How Anti-Substance Abuse Campaigns Influence Substance Abusers' Psychological Health in Chinese Communities: The Mediating Role of Perceived Stigma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116687. [PMID: 35682271 PMCID: PMC9180135 DOI: 10.3390/ijerph19116687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 02/04/2023]
Abstract
The current study explored how anti-substance abuse campaigns influence substance abusers' psychological health through the perception of stigma. The study is based on a sample of substance abusers who received community-based treatments (n = 3457) and used structural equation modeling to estimate the role of perceived stigma in mediating between perceptions of overstatement of harm conveyed in anti-substance abuse campaigns and psychological outcomes. The results revealed that substance abusers' perception of overstatement of the harm caused by the substances and substance abusers enhanced their perceived stigma and impaired their psychological health in terms of anxiety, depression, and somatization, through both direct and indirect pathways. The results advocate for proper strategies in the design of anti-substance abuse campaigns. Possible initiatives to reduce substance abusers' perceived stigma are recommended.
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Affiliation(s)
- Yonghui Zeng
- School of Economics and Statistics, Guangzhou University, Guangzhou 510006, China;
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
| | - Li Han
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
| | - Yu Cheng
- School of Education Science and Law, Xiangnan University, Chenzhou 423043, China
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou 510275, China
- Correspondence: (Y.C.); (C.X.J.)
| | - Cindy Xinshan Jia
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
- Correspondence: (Y.C.); (C.X.J.)
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9
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Treatments, Perceived Stigma, and Employment Outcomes among Substance Abusers in China. Healthcare (Basel) 2022; 10:healthcare10010130. [PMID: 35052293 PMCID: PMC8776030 DOI: 10.3390/healthcare10010130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 12/23/2022] Open
Abstract
Employment is a vital component of a substance abuser's recovery, but little is known about how stigma affects employment for substance abusers receiving treatment. The current study investigates the effects of stigma and treatment on employment in the Chinese context. Using a sample of substance abusers (N = 3.978), multiple logistics regressions with moderation effects were employed. The findings show that treatments positively reduce confirmative experiences of anticipated stigma, and promote employment only when respondents do not perceive stigma. The findings highlight the impact of perceived stigma on limiting substance abusers' chances of being employed, implying that eliminating stigma is the foundation for recovery. Possible strategies that can be explored for reducing stigma are discussed.
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Cheetham A, Picco L, Barnett A, Lubman DI, Nielsen S. The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy. Subst Abuse Rehabil 2022; 13:1-12. [PMID: 35115860 PMCID: PMC8800858 DOI: 10.2147/sar.s304566] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/11/2022] [Indexed: 12/25/2022] Open
Abstract
Illicit drug use disorders are the most stigmatised health conditions worldwide, and stigma acts as a meaningful barrier to treatment entry and treatment provision. In the context of dramatically rising opioid-related harms, it is critical that we understand the drivers of stigma and how it affects opioid use disorder treatment and policy. The aim of this narrative review is to discuss how opioid-related stigma impacts treatment provision and harm reduction, and provide potential strategies to reduce stigma at a social and structural level. We used the Framework for Integrating Normative Influences on Stigma (FINIS) to identify sources of opioid-related stigma at the macro (structural stigma), meso (public stigma) and micro (internalised stigma) levels. Reducing stigma requires strategies that target multiple levels, however addressing inequity in the laws, regulations, and rules that segregate people with opioid and other substance use disorders from mainstream society is essential.
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Affiliation(s)
- Ali Cheetham
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia
- Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Louisa Picco
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia
| | - Anthony Barnett
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia
- Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia
- Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia
- Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
- Correspondence: Suzanne Nielsen, Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, Victoria, 3199, Australia, Tel +61 3 9904 4641, Email
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Friedman SR, Williams LD, Guarino H, Mateu-Gelabert P, Krawczyk N, Hamilton L, Walters SM, Ezell JM, Khan M, Di Iorio J, Yang LH, Earnshaw VA. The stigma system: How sociopolitical domination, scapegoating, and stigma shape public health. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:385-408. [PMID: 34115390 PMCID: PMC8664901 DOI: 10.1002/jcop.22581] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 05/26/2023]
Abstract
Stigma is a fundamental driver of adverse health outcomes. Although stigma is often studied at the individual level to focus on how stigma influences the mental and physical health of the stigmatized, considerable research has shown that stigma is multilevel and structural. This paper proposes a theoretical approach that synthesizes the literature on stigma with the literature on scapegoating and divide-and-rule as strategies that the wealthy and powerful use to maintain their power and wealth; the literatures on racial, gender, and other subordination; the literature on ideology and organization in sociopolitical systems; and the literature on resistance and rebellion against stigma, oppression and other forms of subordination. we develop a model of the "stigma system" as a dialectic of interacting and conflicting structures and processes. Understanding this system can help public health reorient stigma interventions to address the sources of stigma as well as the individual problems that stigma creates. On a broader level, this model can help those opposing stigma and its effects to develop alliances and strategies with which to oppose stigma and the processes that create it.
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Affiliation(s)
- Samuel R Friedman
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Leslie D Williams
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, Illinois, USA
| | - Honoria Guarino
- Institute for Implementation Science in Population Health, CUNY Graduate School of Public Health & Health Policy, New York, New York, USA
| | - Pedro Mateu-Gelabert
- Institute for Implementation Science in Population Health, CUNY Graduate School of Public Health & Health Policy, New York, New York, USA
| | - Noa Krawczyk
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Leah Hamilton
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Suzan M Walters
- NYU Rory Meyers College of Nursing, Interdisciplinary Research Training Institute on Hispanic Drug Abuse, University of Southern California, Los Angeles, California, USA
| | - Jerel M Ezell
- Department of Sociology, University of Chicago, Chicago, Illinois, USA
- Department of Medicine, Section on Global Health and Infectious Diseases, University of Chicago, Chicago, Illinois, USA
| | - Maria Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Jorgelina Di Iorio
- Faculty of Psychology and Intercambios Civil Association, CONICET/Buenos Aires University, Buenos Aires, Argentina
| | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware, USA
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12
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Hook K, Sereda Y, Makarenko O, Bendiks S, Rybak NR, Dutta A, Idrisov B, Drainoni ML, Kiriazova T, Lunze K. TB stigma and its correlates among HIV-positive people who inject drugs in Ukraine. Int J Tuberc Lung Dis 2021; 25:747-753. [PMID: 34802497 PMCID: PMC8716997 DOI: 10.5588/ijtld.21.0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: TB is commonly stigmatized. Correlates of perceived TB stigma have not been assessed specifically among HIV-positive people who inject drugs (PWIDs). It is also unclear how perceived TB stigma intersects with other forms of stigma affecting this population. We aimed to evaluate perceived TB stigma, its correlates and its intersection with HIV and substance use stigma among HIV-positive PWIDs in Ukraine.METHODS: Among 191 participants at three sites across Ukraine, we assessed stigma scores, socio-demographic, behavioral and health-related variables by TB status (history of active TB infection, history of treatment for latent TB infection LTBI, no history of TB infection). We used self-reported history of LTBI treatment as a proxy for LTBI status. We used ordinary least squares to estimate factors associated with perceived TB stigma.RESULTS: Lower perceived TB stigma scores were associated with LTBI status (adjusted beta (aβ) -0.2, 95% CI -0.3 to 0.0; P = 0.032). Higher perceived TB stigma scores were associated with higher substance use stigma scores (aβ 0.1, 95% CI 0.0 to 0.2; P = 0.004). Depressive symptoms were common in this sample, although not significantly associated with TB status.CONCLUSION: History of LTBI treatment appears to impact beliefs about perceived TB stigma. Individuals who endorse higher substance use stigma are more likely to hold stigmatizing perceptions about people with TB. HIV-positive PWIDs with history of active TB infection or LTBI treatment commonly experience mental health distress. This stigma intersection needs further exploration in this population, including of its relation with mental health, to provide further insights for targeted interventions.
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Affiliation(s)
- K Hook
- Department of Psychiatry, Boston Medical Center, Boston, MA, Department of Psychiatry, Boston University School of Medicine, Boston, MA, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Y Sereda
- Ukrainian Institute on Public Health Policy Consultant, Kyiv, Ukraine
| | - O Makarenko
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - S Bendiks
- Department of Medicine, Boston Medical Center, Boston, MA
| | - N R Rybak
- Warren Alpert Medical School of Brown University, Providence, RI
| | - A Dutta
- Internal Medicine, McLaren Flint/Michigan State University, Flint, MI, USA
| | - B Idrisov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia, Bashkir State Medical University, Ufa, Russia, Moscow Institute of Physics and Technology, Moscow, Russia
| | - M-L Drainoni
- Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, Boston University Center for Implementation & Improvement Sciences, Boston, MA, USA
| | - T Kiriazova
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - K Lunze
- Department of Medicine, Boston Medical Center, Boston, MA
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Wallace B, MacKinnon K, Strosher H, Macevicius C, Gordon C, Raworth R, Mesley L, Shahram S, Marcellus L, Urbanoski K, Pauly B. Equity-oriented frameworks to inform responses to opioid overdoses: a scoping review. JBI Evid Synth 2021; 19:1760-1843. [PMID: 34137739 DOI: 10.11124/jbies-20-00304] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to systematically identify and describe literature that uses a health equity-oriented approach for preventing and reducing the harms of stigma or overdose for people who use illicit drugs or misuse prescription opioids. INCLUSION CRITERIA To be included, papers had to both: i) use a health equity-oriented approach, defined as a response that addresses health inequities and aims to reduce drug-related harms of stigma or overdose; and ii) include at least one of the following concepts: cultural safety, trauma- and violence-informed care, or harm reduction. We also looked for papers that included an Indigenous-informed perspective in addition to any of the three concepts. METHODS An a priori protocol was published and the JBI methodology for conducting scoping reviews was employed. Published and unpublished literature from January 1, 2000, to July 31, 2019, was included. The databases searched included CINAHL (EBSCOhost), MEDLINE (Ovid), Academic Search Premier (EBSCOhost), PsycINFO (EBSCOhost), Sociological Abstracts and Social Services Abstracts (ProQuest), JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, PROSPERO, Aboriginal Health Abstract Database, First Nations Periodical Index, and the National Indigenous Studies Portal. The search for unpublished studies included ProQuest Dissertations and Theses, Google Scholar, and targeted web searches. Screening and data extraction were performed by two reviewers using templates developed by the authors. Data extraction included specific details about the population, concepts, context, and key findings or recommendations relevant to the review objectives. RESULTS A total of a total of 1065 articles were identified and screened, with a total of 148 articles included. The majority were published in the previous five years (73%) and were from North America (78%). Most articles only focused on one of the three health equity-oriented approaches, most often harm reduction (n = 79), with only 16 articles including all three. There were 14 articles identified that also included an Indigenous-informed perspective. Almost one-half of the papers were qualitative (n = 65; 44%) and 26 papers included a framework. Of these, seven papers described a framework that included all three approaches, but none included an Indigenous-informed perspective. Recommendations for health equity-oriented approaches are: i) inclusion of people with lived and living experience; ii) multifaceted approaches to reduce stigma and discrimination; iii) recognize and address inequities; iv) drug policy reform and decriminalization; v) ensure harm-reduction principles are applied within comprehensive responses; and vi) proportionate universalism. Gaps in knowledge and areas for future research are discussed. CONCLUSIONS We have identified few conceptual frameworks that are both health equity-oriented and incorporate multiple concepts that could enrich responses to the opioid poisoning emergency. More research is required to evaluate the impact of these integrated frameworks for action.
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Affiliation(s)
- Bruce Wallace
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
| | - Karen MacKinnon
- School of Nursing, University of Victoria, Victoria, BC, Canada
- Centre for Evidence-Informed Nursing and Healthcare (CEiNHC): A JBI Affiliated Group, University of Victoria, Victoria, BC, Canada
| | - Heather Strosher
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
| | - Celeste Macevicius
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
| | - Carol Gordon
- Centre for Evidence-Informed Nursing and Healthcare (CEiNHC): A JBI Affiliated Group, University of Victoria, Victoria, BC, Canada
- Library Service, University of Victoria, Victoria, BC, Canada
| | - Rebecca Raworth
- Library Service, University of Victoria, Victoria, BC, Canada
| | - Lacey Mesley
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
| | - Sana Shahram
- School of Nursing, University of British Columbia: Okanagan campus, Kelowna, BC, Canada
| | - Lenora Marcellus
- School of Nursing, University of Victoria, Victoria, BC, Canada
- Centre for Evidence-Informed Nursing and Healthcare (CEiNHC): A JBI Affiliated Group, University of Victoria, Victoria, BC, Canada
| | - Karen Urbanoski
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
| | - Bernadette Pauly
- Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada
- School of Nursing, University of Victoria, Victoria, BC, Canada
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Meyers SA, Earnshaw VA, D’Ambrosio B, Courchesne N, Werb D, Smith LR. The intersection of gender and drug use-related stigma: A mixed methods systematic review and synthesis of the literature. Drug Alcohol Depend 2021; 223:108706. [PMID: 33901753 PMCID: PMC8168566 DOI: 10.1016/j.drugalcdep.2021.108706] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender, shape experiences of substance use-related stigma. We sought to answer the following question: Do men or women PWUD experience more drug use stigma? METHODS Data were drawn from a systematic review of the global, peer-reviewed scientific literature on substance use-related stigma conducted through 2017 and guided by the Stigma and Substance Use Process Model and PRISMA guidelines. Articles were included in the present analysis if they either qualitatively illustrated themes related to the gendered nature of drug use-related stigma, or quantitatively tested the moderating effect of gender on drug use-related stigma. RESULTS Of the 75 studies included, 40 (53 %) were quantitative and 35 (47 %) were qualitative. Of the quantitative articles, 22 (55 %) found no association between gender and drug use-related stigma, 4 (10 %) identified women who use drugs (WWUD) were more stigmatized, and 2 (5 %) determined men who use drugs (MWUD) were more stigmatized. In contrast, nearly all (34; 97 %) of the qualitative articles demonstrated WWUD experienced greater levels of drug use-related stigma. CONCLUSION The quantitative literature is equivocal regarding the influence of gender on drug use-related stigma, but the qualitative literature more clearly demonstrates WWUD experience greater levels of stigma. The use of validated drug use-related stigma measures and the tailoring of stigma scales to WWUD are needed to understand the role of stigma in heightening the disproportionate harms experienced by WWUD.
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Affiliation(s)
- S. A. Meyers
- Department of Psychology, San Diego State University, 5500
Campanile Drive, San Diego, CA 92182, USA,Division of Infectious Diseases and Global Public Health,
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla,
CA 92093, USA
| | - V. A. Earnshaw
- Human Development and Family Sciences, University of Delaware,
Newark, DE, 19716, USA
| | - B. D’Ambrosio
- Division of Infectious Diseases and Global Public Health,
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla,
CA 92093, USA,School of Social Work, College of Health and Human Services,
San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - N. Courchesne
- Department of Psychiatry, University of California San Diego,
9500 Gilman Drive, La Jolla, CA 92093, USA
| | - D. Werb
- Division of Infectious Diseases and Global Public Health,
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla,
CA 92093, USA,Centre for Urban Health Solutions, St. Michael’s
Hospital, 30 Bond Street, Toronto, ON, M5B 1W8 Canada
| | - L. R. Smith
- Division of Infectious Diseases and Global Public Health,
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla,
CA 92093, USA
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15
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Cernasev A, Hohmeier KC, Frederick K, Jasmin H, Gatwood J. A systematic literature review of patient perspectives of barriers and facilitators to access, adherence, stigma, and persistence to treatment for substance use disorder. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 2:100029. [PMID: 35481114 PMCID: PMC9029901 DOI: 10.1016/j.rcsop.2021.100029] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction The opioid crisis has left a devastating impact on the United States (U.S.) for over 20 years. The over-prescribing of opioid medications and availability of illicit opioids have contributed to the U.S. opioid epidemic. Given the complexity of the epidemic, substance use disorder, and its treatment, there is an urgent need for a thorough review of the qualitative literature which has captured the patient's experiences Such patient-derived qualitative data on lived experiences and perspectives may allow researchers, clinicians, and policy makers to glean new insights into addressing this epidemic. Objectives The objective of this paper is to present a systematic literature review of the existing U.S. qualitative research and provide a patient perspective on medications for opioid use disorder (MOUD), including barriers and facilitators to MOUD use. Methods In November 2019, four electronic databases (PubMed, CINAHL, Scopus, and Web of Science) were searched by a medical librarian using a combination of keywords, Medical Subject Headings (MeSH), and/or CINAHL subject headings. 8766 results were imported into EndNote, then duplicate records were removed, leaving a total of 4722 articles. The unique records were imported into Rayyan QCRI an online platform designed to expedite screening. Blinded screening was undertaken in duplicate by four reviewers. Two researchers abstracted all the articles and used thematic analysis. Results The screening in the abstract phase excluded 4681 results, leaving 41 studies for full-text screening to determine their eligibility for inclusion in the review. After screening, 21 articles were included in the study and the analysis is based on these articles Common themes across studies included stigmatization, perceived barriers to MOUD, and MOUD treatment deserts and provider shortages. Conclusions Qualitative research studies conducted to date have uncovered substantial MOUD treatment barriers which are both social and structural in nature. Such barriers to treatment may serve to exacerbate the current epidemic and must be taken into consideration in designing policy and treatment solutions for patients with OUD.
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Affiliation(s)
- Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences Center, Nashville, TN, USA
| | - Kenneth C. Hohmeier
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences Center, Nashville, TN, USA
| | - Kelsey Frederick
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences Center, Nashville, TN, USA
| | - Hilary Jasmin
- Health Sciences Library, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Justin Gatwood
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences Center, Nashville, TN, USA
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16
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Kapadia SN, Katzman C, Fong C, Eckhardt BJ, Guarino H, Mateu-Gelabert P. Hepatitis C testing and treatment uptake among young people who use opioids in New York City: A cross-sectional study. J Viral Hepat 2021; 28:326-333. [PMID: 33141503 PMCID: PMC8207521 DOI: 10.1111/jvh.13437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 09/22/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022]
Abstract
Young people who use drugs have a rising hepatitis C (HCV) incidence in the United States, but they may face barriers to testing and treatment adoption due to stigma. We conducted a cross-sectional study of New York City residents aged 18-29 years who reported non-medical prescription opioid and/or heroin use in the past 30 days. Participants were recruited from the community between 2014-2016 via respondent-driven sampling. Participants completed an in-person structured survey that included questions about HCV testing and treatment and received HCV antibody testing. There were 539 respondents: 353 people who inject drugs (PWID) and 186 non-PWID. For PWID, median age was 25 years, 65% were male and 73% non-Hispanic White. For non-PWID, median age was 23 years, 73% were male and 39% non-Hispanic White. 20% of PWID and 54% of non-PWID had never been tested for HCV (P < .001). Years since first injection (aOR 1.16, CI: 1.02-1.32, P = .02) and history of substance use treatment (aOR 3.17, CI: 1.53-6.61, P = .02) were associated with prior testing among PWID. The seroprevalence of HCV among PWID was 25%, adjusted for sampling weights. Of the 75 who were aware of their HCV-positive status, 53% had received HCV-related medical care, and 28% had initiated treatment. HCV prevalence among young PWID is high, and many have never been tested. Injection experience and treatment engagement is associated with testing. Interventions to increase testing earlier in injection careers, and to improve linkage to HCV treatment, will be critical for young PWID.
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Affiliation(s)
- Shashi N Kapadia
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA
| | - Caroline Katzman
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Chunki Fong
- Institute for Implementation Science in Population Health, City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Benjamin J Eckhardt
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Honoria Guarino
- Institute for Implementation Science in Population Health, City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Pedro Mateu-Gelabert
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA
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17
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Thu Trang N, Jauffret-Roustide M, Minh Giang L, Visier L. How to be self-reliant in a stigmatising context? Challenges facing people who inject drugs in Vietnam. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 87:102913. [PMID: 32855011 PMCID: PMC8118722 DOI: 10.1016/j.drugpo.2020.102913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/17/2020] [Accepted: 08/09/2020] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- Nguyen Thu Trang
- Centre for Research and Training on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Vietnam.
| | - Marie Jauffret-Roustide
- Centre for Research and Training on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Le Minh Giang
- Centre for Research and Training on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Laurent Visier
- Centre for Research and Training on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Vietnam
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18
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Grigsby TJ, Forster M, Sussman S. Preliminary psychometric evaluation of the micro-condescension scale for individuals in substance use treatment. J Addict Dis 2019; 37:87-95. [DOI: 10.1080/10550887.2018.1557991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Timothy J. Grigsby
- Department of Kinesiology, Health, and Nutrition, University of Texas, San Antonio, TX, USA
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, CA, USA
| | - Steve Sussman
- Departments of Preventive Medicine and Psychology, University of Southern California, Los Angeles, CA, USA
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19
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Hammarlund R, Crapanzano KA, Luce L, Mulligan L, Ward KM. Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders. Subst Abuse Rehabil 2018; 9:115-136. [PMID: 30538599 PMCID: PMC6260179 DOI: 10.2147/sar.s183256] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Substance-use disorders are a public health crisis globally and carry with them significant morbidity and mortality. Stigma toward people who abuse these substances, as well as the internalization of that stigma by substance users, is widespread. In this review, we synthesized the available evidence for the role of perceived social stigma and self-stigma in people’s willingness to seek treatment. While stigma may be frequently cited as a barrier to treatment in some samples, the degree of its impact on decision-making regarding treatment varied widely. More research needs to be done to standardize the definition and measurement of self- and perceived social stigma to fully determine the magnitude of their effect on treatment-seeking decisions.
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Affiliation(s)
- R Hammarlund
- Our Lady of the Lake Division of Academic Affairs, Baton Rouge, LA, USA
| | - K A Crapanzano
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA,
| | - L Luce
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA,
| | - L Mulligan
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA,
| | - K M Ward
- Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA,
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20
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Guarino H, Mateu-Gelabert P, Teubl J, Goodbody E. Young adults' opioid use trajectories: From nonmedical prescription opioid use to heroin, drug injection, drug treatment and overdose. Addict Behav 2018; 86:118-123. [PMID: 29747875 DOI: 10.1016/j.addbeh.2018.04.017] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 04/01/2018] [Accepted: 04/25/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Recent research has begun to explore the transition from nonmedical use of prescription opioids (POs) to heroin and injection drug use, adding to earlier literature identifying factors that influence the transition from intranasal to injection use of heroin. However, little research has explored how these transitions are embedded within young people's broader opioid use trajectories - individual pathways that may also include experiences of nonfatal overdose and drug treatment. METHODS Data are from a study of 539 18-29 year-old New York City residents, recruited via Respondent-Driven Sampling, who reported past-month nonmedical use of POs and/or heroin use. Participants completed structured, computer-assisted interviews that included assessment of their ages at a series of "benchmark" events and experiences, including first use of a drug or route of administration, the onset of "regular" use of a drug (i.e., 1 or more times a week for at least 1 month), first overdose and first drug treatment. RESULTS Results suggest a predictable, ordered pathway by which opioid use tends to progress in this cohort of young adults. Participants initiated nonmedical PO use at age 16.8, on average, and most transitioned to heroin use (83%) and heroin injection (64%), generally within 4 years of first PO misuse. Drug treatment was not typically accessed until after participants had progressed to heroin use. First overdose occurred <1 year after first heroin use, on average. CONCLUSIONS Findings may help inform the optimal timing for delivery of primary, secondary and tertiary prevention efforts targeting young opioid users.
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Affiliation(s)
- Honoria Guarino
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), 71 W. 23rd St., 4th Fl., New York, NY 10010, USA.
| | - Pedro Mateu-Gelabert
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), 71 W. 23rd St., 4th Fl., New York, NY 10010, USA.
| | - Jennifer Teubl
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), 71 W. 23rd St., 4th Fl., New York, NY 10010, USA; Sackler Institute of Graduate Biomedical Sciences, New York Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.
| | - Elizabeth Goodbody
- Institute for Infectious Disease Research, National Development and Research Institutes (NDRI), 71 W. 23rd St., 4th Fl., New York, NY 10010, USA.
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