Interventions to Reduce Stigma Related to People who Use Drugs: Systematic Review

Abstract

Interventions to reduce stigma related to people who use drugs can improve their quality of life and adherence to treatment. This review aimed to identify and analyze studies on interventions to reduce the stigma related to people who use drugs. Searches were performed in the following databases, without period delimitation: PubmMed, APA PsycNET, ScienceDirect, Web of Science, and VHL. Considering secondary referencing, we identified a total of 5,488 records. This review covered 28 articles and was based on PRISMA. Although target audiences comprising students and health professionals were predominant, as well as the use of quantitative methods, sample size and interventions varied among studies. The selected studies present considerable methodological limitations. We concluded that no evidence confirms the effectiveness of the proposed interventions and which of them should continue to be applied for this specific aim. It is essential to invest in approaches other than those traditionally adopted.

Attitudes of health professionals towards people with substance use disorders in Brazil, controlling for the effects of social desirability

“…From this perspective, the type of approach that training courses in colleges and universities have been taking on this subject calls our attention. Much teaching is still based on a reductionist and ahistorical understandings of addiction, failing to emphasise a holistic view of health, which considers the importance of social determinants of health, the complex biopsychosocial processes involved in addiction, and the necessary articulation and communication between sectors for collaborative health promotion work (Costa & Paiva, 2016; Tostes et al., 2020).…”

“…Such conceptions, aligned with an understanding of the contexts of use and the processes of stigmatisation against users, can materialise a greater professional commitment to defending the human and political rights of people with SUDs (Rigotti et al, 2016; Tostes et al., 2020). In this way, we can think of a political dimension immersed in a systemic logic of attitudes, which goes beyond the direct contact between professional and user, and also encompasses participation in the construction of policies that guarantees the well‐being of beneficiaries of services, ensures satisfactory public funding, and better working conditions, for example, and other policies (Ferreira et al., 2021).…”

“…The literature also points out that the lack of motivation to help is very present and professionals feel fearful and less confident because of being undertrained in substance use and addiction, which in turn contributes to and reinforces a desire for social distance (Ferreira et al., 2019; Monks et al., 2012; Yang et al., 2017). Issues like these decrease the chances of establishing a good partnership between professionals and clients, since the latter may not feel comfortable discussing their situations or starting/continuing treatment for fear of adverse behaviours from their providers (van Boekel et al., 2013; Brown, 2015; Tostes et al., 2020). This can lead to reduced chances of recovery, less satisfactory results in treatment, social exclusion and withdrawal of users from health services in general (Ferreira et al., 2019; Silveira et al., 2018).…”

The Life Unites Us Campaign: A Novel Approach to Addressing Stigma against Opioid Use Disorder

“…31 32 Some evidence has suggested that interventions to reduce substance use stigma should adopt multiple strategies at the outset, be longer-term, and focus on various aspects of attitudes toward people who use drugs. 33 A larger evidence base around HIV and mental health stigma reduction strategies also show promise in the use of digital strategies to reduce public stigma, particularly when using knowledge building and firstperson narrative storytelling. 34 35 36 37 38 Given the clear impact of stigma on health outcomes Pennsylvania's Department of Drug and Alcohol Programs (DDAP) has highlighted OUD stigma reduction as one of their key 2019-2022 strategic goals.…”

Life unites us: A novel approach to addressing opioid use disorder stigma

“…Evidence from HIV and mental health stigma reduction has shown promise in digital approaches, particularly by using knowledge building and first-person narrative storytelling (Clement et al, 2013; Daher et al, 2017; Kerr et al, 2015; National Academies of Sciences and Medicine, 2016; The Public Good Projects, 2019). Other evidence has suggested that programmes and interventions to reduce substance use stigma should adopt multiple strategies, be longer-term and focus on various aspects of attitudes towards PWUD (Tostes et al, 2020).…”