The Relationship between Drug User Stigma and Depression among Inner-City Drug Users in Baltimore, MD

Abstract

There is growing awareness of the role of stigma and discrimination in HIV prevention, testing, and medical care. Yet, few studies have examined the stigma associated with using illicit drugs. In the present study, we examined the relationship between social network characteristics, drug user stigma, and depression. Study participants were comprised of 340 individuals who reported cocaine, crack, and/or heroin use in the prior 6 months and were involved in an HIV prevention study. They were recruited through street outreach, referrals, and word of mouth in inner-city Baltimore, MD, USA. The stigma scale was comprised of eight items, such as "how much do you feel ashamed of using drugs?" Depression was assessed with the Center for Epidemiological Studies Depression Scale, using cutoffs of 16 and 20 or greater. In the bivariate analyses, gender, homelessness in the past 6 months, drug user stigma, larger size of drug network, and current use of heroin, cocaine, and crack were all significantly associated with high levels of depression, whereas in the multivariate analyses, only drug user stigma remained significantly associated with depression. The results of this study suggest that drug treatment providers and other professionals who provide services to drug users should consider developing trainings to address drug user stigma. These programs should focus on the attitudes and behaviors of health and service providers toward drug users, among drug users themselves, and among family members and others who provide social support to drug users.

Motivations and repercussions regarding crack consumption: the collective discourse of users of a Psychosocial Care Center

“…[16][17][18] The repercussions collaborate to the development and worsening of impulsivity, which directs individuals to do more shortsighted choices without assessing the impact. 19 Regarding mental health, a study conducted in the United States 20 confirms that the use of crack is significantly associated with high levels of depression. Research conducted in Nicaragua also adds risk of anxiety, bipolar disorder and schizophrenia.…”

Stigma in the Dutch Health Care Sector: HIV-Positive Substance Users’ Experiences and Health Care Providers’ Perspectives

“…It is therefore important to engage in efforts to reduce the stigmatization of substance users with HIV in health care settings, and to improve interactions between health care professionals and substance users with HIV. In order to do this effectively, an understanding of how these interactions are perceived is necessary [29]. The current literature on HIV-positive substance users' experiences in health care settings is relatively limited, as is the literature on health care providers' perceptions of substance users with HIV.…”

A rede de apoio social de usuários de crack acompanhados por um equipe de consultório na rua de uma cidade no interior de Minas Gerais

“…A partir da leitura desses artigos, identificou-se que, nos estudos recentes sobre a temática, têm-se focado principalmente as características da rede social dos usuários (GRIFFIN; RODRIGUEZ, 2011;RUDOLPH et al, 2011;JONAS et al, 2012;LATKIN et al, 2012;NYAMATHI et al, 2012;WENZEL et al, 2012;BUTTRAM;KURTZ;SURRAT, 2013;RUDOLPH et al, 2013;BOODRAM;MACKESY-AMITIA, LATKIN, 2015;KING;LATKIN, DAVEY-ROTHWWLL, 2015;SONG;WENZEL, 2015;SCHERER et al, 2016;SMITH et al, 2016), os fatores de risco, da rede social, em relação ao uso de drogas (DOHERTY et al, 2011;RHOADES et al, 2011;TOBIN et al, 2011;CRAWFORD et al, 2013;KELLY et al, 2013;MAUSLBY et al, 2014;GUNN;CANADA, 2015;FUJIMOTO et al, 2016) e os fatores de proteção, da rede social, em relação ao uso de drogas (BOOTH et al, 2011;TRENZ et al, 2012;CHARLEBOIS et al, 2012;OSER, LEUKERFELD, 2012;RAMASWAMY et al, 2013;SAPRA et al, 2013;HUDSON;NANDY, 2014;JORGE, 2014;HEARN et al, 2015;CUCCIARE et al, 2016;HORTA et al, 2016;MCNEIL et al, 2015).…”

“…No que diz respeito às populações estudadas, em tais estudos trabalhou-se com indivíduos com privação da liberdade (GRIFFIN E RODRIGUEZ, 2011;LEUKEFELD, 2012), população rural (DOHERTY et al, 2011;JONAS et al, 2012;CUCCIARE et al, 2016;SMITH et al, 2016), homossexuais (Tobin et al, 2011;KELLY et al, 2013;BUTTRAM;KURTZ;SURRAT, 2013;MAULSBY et al, 2014;FUJIMOTO et al, 2016), pessoas com baixa renda (KING; LATKIN, DAVEY-ROTHWWLL, et al, 2015;, sujeitos em situação de rua (RHOADES et al, 2011;NYAMATHI et al, 2012;WENZEL et al, 2012;HUDSON;NANDY, 2014;SONG;WENZEL, 2015), usuários de crack e outras drogas (BOOTH et al, 2011;RUDOLPH et al, 2011;TRENZ et al, 2012;LATKIN et al, 2012;CRAWFORD et al, 2013;RAMASWAMY et al, 2013;RUDOLPH et al, 2013;SAPRA et al, 2013;BOODRAM;MACKESY-AMITIA;GUNN;CANADA, 2015;HEARN et al, 2015). Destaca-se que apenas em alguns desses estudos trabalhou-se exclusivamente com os usuários de crack (CHARLEBOIS et al, 2012;HORTA et al, 2016;SCHERER et al, 2016;JORGE, 2014;MCNeil et al, 2015)…”

“…Em relação à caracterização da rede social dos usuários de drogas, diversos autores (GRIFFIN; RODRIGUEZ, 2011;RUDOLPH et al, 2011;JONAS et al, 2012;LATKIN et al, 2012;NYAMATHI et al, 2012;WENZEL et al, 2012;BUTTRAM;KURTZ, 2013;RUDOLPH et al, 2013;BOODRAM;MACKESY-AMITIA;KING;DAVEY-ROTHWWLL, 2015;SONG;WENZEL, 2015;SCHERER et al, 2016;SMITH et al, 2016) (DOHERTY et al, 2011;TOBIN et al, 2011;KELLY et al, 2013;MAULSBY et al, 2014;FUJIMOTO et al, 2016), estigma e discriminação (CRAWFORD et al, 2013;GUNN;CANADA, 2015) e viver em situação de rua (RHOADES et al, 2011;TRENZ et al, 2012;HUDSON;NANDY, 2014 No tocante ao estigma e discriminação, em um estudo conduzido por Crawford et al (2013), em Nova York, teve-se como objetivo analisar a associação entre preconceito por raça, uso de drogas ou histórico carcerário e a rede social de usuários de drogas ilícitas. Foi apresentado em seus achados, que os participantes que relataram ter sofrido discriminação devido à raça e ao uso de drogas tinham em suas redes sociais mais vínculos que apresentavam risco tanto para uso de drogas quanto para comportamento sexual de risco.…”