Ambiguous identities of drugs and people: A scoping review of opioid-related stigma

McCradden, Melissa D; Vasileva, Denitsa; Orchanian‐Cheff, Ani; Buchman, Daniel Z.

doi:10.1016/j.drugpo.2019.10.005

Cited by 88 publications

(98 citation statements)

References 89 publications

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“…While many of the participants in our study indicated they have experienced stigmatization, those who used illicit substances -opiates in particular -more commonly reported experiencing this access barrier. In line with the literature, stigmatization can manifest differentially, depending on the substance(s) used, as well as the context of individual substance use, yet it often perpetuates marginalization regardless [68][69][70]. Employing and utilizing PWLE's unique knowledge and expertise holds the ability to further combat discrimination as services can be provided in a non-judgemental manner.…”

Section: Discussionmentioning

confidence: 79%

WITHDRAWN: Examining Substance Use Services and Treatment Barriers and Needs among People with Lived Experience (PWLE) in Ontario, Canada.

Russell

Ali

Nafeh

et al. 2020

Preprint

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Introduction: Substance use is a complex issue, with rates of illicit and licit substances varying across Canada, and in Ontario, specifically. Services and treatment options for problematic substance use remain vital. Recent initiatives to increase the effectiveness of services have been implemented, however, a disconnect remains between the availability and accessibility of these programs and the real-world experiences and needs of people with lived experience (PWLE). There is a lack of knowledge regarding barriers to accessing services and service needs, yet PWLE are best suited to identify these factors. As such, this study critically examined these issues among a cohort of PWLE in Ontario, Canada. Methods: Semi-structured, one-on-one interviews with n=50 adult PWLE participants were conducted. Participants were recruited from substance use services across Ontario, based on ConnexOntario’s directory of all provincial addiction services, as well as by word-of-mouth. Questions focused on participants’ experiences and perspectives on substance use services. All data were transcribed and underwent an inductive thematic analysis based on key themes that emerged. Results: Beneficial services identified varied based on participant experiences and needs. A variety of barriers to service access were acknowledged, primarily related to system-level issues such as an overall lack of services, a lack of service capacity, and a severe lack of service coordination and gaps in service delivery. Recommendations revolved around the need for low-barrier, affordable, seamless services run by non-judgemental staff, including fellow PWLE. Conclusions: This study identified needs and barriers to substance use care among PWLE in Ontario, and highlighted important areas for policy change and program planning and implementation. Concrete recommendations include the development of a government-funded, low-barrier, comprehensive and integrated model of substance use services that includes PWLE as collaborators and program facilitators to ensure that services are as successful and meaningful as possible. Results from this study will work towards the improvement of substance use treatment and service provision across the province.

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Section: Discussionmentioning

confidence: 79%

WITHDRAWN: Examining Substance Use Services and Treatment Barriers and Needs among People with Lived Experience (PWLE) in Ontario, Canada.

Russell

Ali

Nafeh

et al. 2020

Preprint

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“…For instance a desire for normality and stability may motivate recovery attempts, yet normal life is also seen as boring (27). Our findings reflect the wider literature on the experience of stigma in substance use disorder more generally (60)(61)(62)(63) and to opioid users specifically (64)(65)(66).…”

Section: [Insert Figure 3 Here]supporting

confidence: 73%

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Carlisle¹,

Maynard²,

Padmanathan³

et al. 2020

Preprint

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Background and Aims Recovery outcomes for opioid substitution treatment are poorer than those for alcohol and other drugs. In order to understand why this is and to synthesise the findings of a large number of qualitative studies, we conducted a systematic review and thematic synthesis to understand facilitators of and barriers to recovery from opioid dependency. Methods Electronic databases (Pubmed, PsychInfo, CINAHL and Embase) were searched. English language studies exploring the views of adult service user and stakeholders with experiences of opioid substitution treatment were considered for inclusion. Included studies were inductively analysed using thematic synthesis. During analysis, the socioecological model was selected as an analytical framework for organising and making links between themes as it captured the complexity of the topic well. ResultsFrom 3646 screened papers, we included 37 studies reporting the views of 1212 staff and service users. Studies highlighted complex interactions between factors influencing recovery across the five levels of the socioecological model (intrapersonal, inter-personal, organisational, community and policy). Early life experiences of trauma were common; lack of support (both psychological and social) was also a recurring theme resulting in feelings of disconnection and isolation. Stigma played a particularly important role in an individual’s capacity to recover from opioid dependency and cut-across all levels of the socioecological model. Conclusions Interventions targeted at the individual level fail to take account of the complexity of recovery within opioid substitution treatment and may ignore the complex socio-political context that service users and services exist within. Stigma permeates all levels of the opioid substitution treatment system; we suggest that addressing this is likely to improve healthcare encounters, help-seeking, increase access to social support and facilitate community reintegration for individuals receiving opioid substitution treatment.

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“…8 Low clinician confidence in treating chronic pain may make it difficult for patients to find a provider. 9 Additionally, patients with chronic pain commonly experience stigma, manifesting as clinician disbelief in their pain, 10,11 a view that opioids are illegitimate treatment, 12 or assumption of an opioid use disorder. [13][14][15] This stigma may affect clinician-patient relationships and further reduce the number of clinicians willing to treat chronic pain.…”

Section: Introductionmentioning

confidence: 99%

Opioid Policy and Chronic Pain Treatment Access Experiences: A Multi-Stakeholder Qualitative Analysis and Conceptual Model

Slat¹,

Yaganti²,

Thomas³

et al. 2021

JPR

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Ambiguous identities of drugs and people: A scoping review of opioid-related stigma

Cited by 88 publications

References 89 publications

WITHDRAWN: Examining Substance Use Services and Treatment Barriers and Needs among People with Lived Experience (PWLE) in Ontario, Canada.

WITHDRAWN: Examining Substance Use Services and Treatment Barriers and Needs among People with Lived Experience (PWLE) in Ontario, Canada.

Factors influencing recovery in opioid substitution treatment: a systematic review and thematic synthesis

Opioid Policy and Chronic Pain Treatment Access Experiences: A Multi-Stakeholder Qualitative Analysis and Conceptual Model

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