Stigma and social barriers to accessing timely healthcare for alcohol dependence and misuse: a narrative review

Abstract

This narrative review looks at how alcohol misuse can be distinguished from unproblematic alcohol consumption, and it considers the extent of alcohol use in the UK, along with the cost of alcohol, financial and otherwise, to individuals and wider society. It focuses on the perceived public stigma and personal stigma associated with alcohol misuse and dependence and how this can discourage people from seeking help from healthcare services. This includes the negative impact of stigmatising language in reinforcing stereotypes and creating expectations. The article explores alcohol-related readmissions and the emotional consequences of ‘revolving-door syndrome’ for patients and professionals. Recommendations are made for hospital screening for risky lifestyle factors, as well as professional education on alcohol screening and interventions. The article concludes with recommendations for further study, to not lose sight of the patient and to destigmatise language to break down barriers to treatment access.

Transient Elastography and Video Recovery Narrative Access to Support Recovery From Alcohol Misuse: Development of a Novel Intervention for Use in Community Alcohol Treatment Services

“…Narrators of videos in the KLIFAD collection gave consent for their specific use in alcohol treatment settings. We did not ask for general consent for public use so as not to deter potential narrators from participation, given the persisting stigma around alcohol misuse [ 25 ]. However, 2 sample videos have been published with additional informed consent from narrators who are also PPI consultants to the KLIFAD study and who have previously shared their own accounts in public [ 26 , 27 ].…”

Why stigma matters in addressing alcohol harm

“…Nonetheless, dissipating the still dominant narrative of alcoholism and its associated stereotypes in all contexts outside of self-labelling (i.e., within Alcoholics Anonymous) is an essential first-line strategy. This includes within alcohol research and practice where stigmatising terminology still persists in journal names, manuscripts [73] and clinical settings [18,19]. Doing so will help shift the public towards a non-stigmatising master narrative within which efforts to address the structural and other aspects of alcohol stigma can be advanced.…”

“…The stigma of alcohol problems remains persistently highmore so than many other medical, substance or mental health problems-and is pervasive in its prevalence and harmful consequences [13,14]. Alcohol stigma is well established as a major barrier to help-seeking and treatment engagement [15][16][17] and multiple forms of overt or subtle discrimination against people with alcohol use disorder (AUD), including by healthcare practitioners [13,18,19].…”