Correlates of public support toward federal funding for harm reduction strategies

Kulesza, Magdalena; Teachman, Bethany A.; Werntz, Alexandra; Gasser, Melissa L.; Lindgren, Kristen P.

doi:10.1186/s13011-015-0022-5

Cited by 45 publications

(44 citation statements)

References 42 publications

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“…Although preliminary, these results raise important questions for future investigations about the value of targeting implicit addiction stigma to promote better care for PWIDs and others coping with SUDs. In light of research suggesting that moralistic, punitive beliefs are related to lower support for funding of healthcare services for SUDs (Kulesza et al, 2015; MacCoun, 2013), effective strategies to address implicit beliefs that PWIDs (especially Latino/a) are more deserving of punishment than help may one day improve access to help for this underserved population.…”

Section: Discussionmentioning

confidence: 99%

“…), among the general public (Kulesza et al, 2015; Lee and Rasinski, 2006; MacCoun, 2013; Matheson et al, 2013). Thus, moralistic and punitive views towards individuals who use drugs seem to be adversely related to availability of help services for SUDs (Kulesza et al, 2015; MacCoun, 2013). On the individual-level, persons with SUDs might decide against seeking help to avoid anticipated stigma from healthcare providers, employers, and/or neighbors (Link et al, 2001, 1989).…”

Section: Introductionmentioning

confidence: 99%

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Towards greater understanding of addiction stigma: Intersectionality with race/ethnicity and gender

Kulesza

Matsuda

Ramirez

et al. 2016

Drug and Alcohol Dependence

Self Cite

129

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Background In spite of the significant burden associated with substance use disorders, especially among persons who inject drugs (PWIDs), most affected individuals do not engage with any type of formal or informal treatment. Addiction stigma, which is represented by negative social attitudes toward individuals who use alcohol and/or other drugs, is one of the barriers to care that is poorly understood. The current study: a) assessed implicit (indirect and difficult to consciously control) and explicit (consciously controlled) beliefs about PWIDs among visitors to a public web site; and b) experimentally investigated the effects of ethnicity/race and gender on those implicit and explicit beliefs. Methods N=899 predominantly White (70%) and women (62%) were randomly assigned to one of six target PWIDs conditions: gender (man/woman) x race/ethnicity (White, Black, Latino/a). Participants completed an Implicit Association Test and explicit assessment of addiction stigma. Results Participants implicitly associated PWIDs (especially Latino/a vs. White PWIDs) with deserving punishment as opposed to help (p =.003, d = .31), indicating presence of addiction stigma-related implicit beliefs. However, this bias was not evident on the explicit measure (p = .89). Gender did not predict differential implicit or explicit addiction stigma (p = .18). Conclusions Contrary to explicit egalitarian views towards PWIDs, participants' implicit beliefs were more in line with addiction stigma. If replicated and clearer ties to behavior are established, results suggest the potential importance of identifying conditions under which implicit bias might influence behavior (even despite explicit egalitarian views) and increase the likelihood of discrimination towards PWIDs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Towards greater understanding of addiction stigma: Intersectionality with race/ethnicity and gender

Kulesza

Matsuda

Ramirez

et al. 2016

Drug and Alcohol Dependence

Self Cite

129

View full text Add to dashboard Cite

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“…While stigma towards substance use and people who use substances is well-documented (Kennedy-Hendricks et al, 2016, 2017; Kulesza et al, 2015; MacCoun, 2013; Pescosolido et al, 2010), its impact on stigmatized persons continues to be understudied and poorly understood (Corrigan et al, 2017; Kulesza et al, 2013; National Academies of Sciences, Engineering, and Medicine, 2016; Smith et al, 2016). We add to the literature by evaluating the relationship between internalized stigma and substance use problems (SUP), defined as negative consequences of substance use such as legal or financial problems (Blanchard et al, 2003).…”

Section: 0 Introductionmentioning

confidence: 99%

Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support

Kulesza

Watkins

Ober

et al. 2017

Drug and Alcohol Dependence

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Background Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs). Methods We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs. Regression analyses examined the relationship between internalized stigma and substance use problems, controlling for demographics, psychiatric comorbidity, and quantity/frequency of use. Results The majority of participants reported thinking, at least sometimes, that they “have permanently screwed up” their lives (60%), and felt “ashamed” (60%), and “out of place in the world” (51%) as a result of their opioid or alcohol use. Higher internalized stigma was significantly related to more substance use problems (β = 2.68, p<0.01), even after the effects of covariates were accounted for. Stigma added 22%, out of 51% total variance explained, leading to a significant improvement in prediction of substance use problems. Conclusions Among this group of primary care patients with OAUDs, rates of internalized stigma were comparable to those reported in specialty substance use treatment settings. Consistent with extant specialty care literature, our results suggest that internalized stigma may be a unique contributor that is associated with treatment outcomes, such as substance use problems, among primary care patients with OAUDs.

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“…Part Two: Literature Review The history of stigma associated with illicit drug use and PWUD continues to negatively impact the quality and availability of evidence-based harm reduction services (Kulesza, Teachman, Werntz, Gasser, & Lindgren, 2015;Pauly, 2008a;Wild, et al, 2017). The benefits of harm reduction are well documented .…”

Section: Guidelines To Destigmatize Harm Reduction Workmentioning

confidence: 99%

“…In the U.S., a 2015 study showed 81% of participants somewhat to strongly supported NSPs, and 60% somewhat to strongly supported SIFs (Kulesza et al, 2015). Two decades ago, Blendon and Younge (1998) researched American attitudes towards policies established under the war on drugs mentality.…”

Section: Public Perceptionsmentioning

confidence: 99%

Guidelines to destigmatize harm reduction: How stigma and misperceptions impede benefits of evidence-based drug policy

Schembri¹

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Despite the wealth of literature supporting a harm reduction approach to substance use, it remains challenging to implement evidence into policy. As Canada expands its harm reduction services, it is important to address that controversial community perceptions of harm reduction and substance use negatively impact the goals of this work. GUIDELINES TO DESTIGMATIZE HARM REDUCTION WORK viii Acknowledgements The completion of this project included the input and support of a number of people whom I am deeply grateful for, and would like to acknowledge. My project supervisor, Dr. Linda O'Neill, has been supportive and accommodating throughout this journey. She encouraged me to choose an education path, research topic, and process, that most inspires and works for me. Her guidance has been enriching beyond the scope of this project. My project committee members, Dr. Joanna Pierce and Dr. John Sherry, were invaluable in providing thoughtful feedback that strengthened both the academic writing and the practical application aspects of this project. Their time and expertise elevated my work. My friend, Kate, has been walking this path with me through countless study sessions, making the good times more fun than research should be, and growing with me through the hard times. My friends, Lauren and Pawel, helped me edit and organize my thoughts and ideas. My partner, Lucian, grounded my life apart from my project. He reminds me where my heart is. Finally, my mom and dad have provided endless love and support. Throughout my academic life, my dad always came through with printer support at inconvenient times, and my mom has read all my papers since grade school without protesting the late nights or early mornings she's put in to help me meet deadlines. My love and gratitude are immeasurable. GUIDELINES TO DESTIGMATIZE HARM REDUCTION WORK 1 Part One: Introduction The opioid crisis in Canada has brought urgency to reevaluating our country's response to drug use. The traditional model of drug control, enforcement and criminalization, has failed to deter drug use (UK Home Office, 2014; Zábranský, 2004) and has had the perverse effect of increasing harms associated with drug use (Beletsky et al., 2014; Global Commission on HIV and the Law, 2012; Kerr, Small & Wood, 2005; Werb et al., 2011). Thousands of preventable deaths indicate that efforts to reduce the harms associated with drug use are lacking. Experts in health and policy, such as the World Health Organization, the United Nations Office on Drugs and Crime, the Joint United Nations Program on HIV/AIDS, the Global Commission on Drug Policy, and the Global Commission on HIV and the Law, are calling for a shift from a criminal model of drug policy to a harm reduction model (Global Commission on Drug Policy, 2016; Global Commission on HIV and the Law, 2012; WHO, UN Office on Drugs and Crime & UN Joint Programme on HIV/AIDS, 2012). Harm reduction services like needle and syringe programs (NSP), opioid agonist treatment (OAT) and safe injection facilities (SIF) have been effective i...

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Correlates of public support toward federal funding for harm reduction strategies

Cited by 45 publications

References 42 publications

Towards greater understanding of addiction stigma: Intersectionality with race/ethnicity and gender

Towards greater understanding of addiction stigma: Intersectionality with race/ethnicity and gender

Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support

Guidelines to destigmatize harm reduction: How stigma and misperceptions impede benefits of evidence-based drug policy

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