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Addiction Medicine pp 1195–1215Cite as

Substance Use Stigma as a Barrier to Treatment and Recovery

Abstract

Stereotypes and judgments about people with substance misuse problems are extremely prevalent and negative. These negative evaluations are made not only by those who abstain from substance use, termed public stigma, but also by those who themselves use and abuse substances, termed self-stigma. While the exact form of discrimination may vary across different substances and social groups, research indicates that substance misuse appears to be at least as stigmatized as psychological disorders such as depression, schizophrenia, or borderline personality disorder. As used conventionally, stigma refers to an attribute or characteristic of an individual that identifies him or her as different in some manner from a normative standard and marks that individual to be socially sanctioned and devalued. This chapter outlines theories of stigma in relation to addiction. Types and levels of stigma are described, including structural versus individual stigma and public versus self-stigma. It is argued that stigma is a complex phenomenon that needs to be studied in context as its effects may vary across levels of analysis and across populations. Also outlined is the existing scientific literature on the impact of self-stigma, the role of stigma in the social networks of those with addiction, and the impact of stigma in treatment settings. Finally, interventions to reduce stigma are described and data on effectiveness are reviewed. Research on stigma in addiction is sparse, and much more research is needed to improve the effectiveness of these interventions.

Keywords

  • Stigma
  • Shame
  • Addiction
  • Substance use disorder

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  1. Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, 97212, USA

    Jason B. Luoma

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  1. , Depts Psychiat & Neurobehav Sciences, Me, University of Virginia, Charlottesville, 22908, Virginia, USA

    Bankole A. Johnson

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Luoma, J.B. (2010). Substance Use Stigma as a Barrier to Treatment and Recovery. In: Johnson, B. (eds) Addiction Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0338-9_59

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