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

Abstract

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.

A qualitative study on intersectional stigma and sexual health among women on opioid substitution treatment in England: Implications for research, policy and practice

“…are commonly not used in non-consensual sex) (Booth et al, 2000;Tyndall et al, 2002;Strathdee, 2003;Strathdee and Sherman, 2003;Strathdee and Stockman, 2010;El-Bassel et al, 2011;El-Bassel et al, 2005;Des Jarlais et al, 2011;Edelman et al, 2014;Kulesza et al, 2016). Ultimately women are particularly at risk of violence mostly because of gender inequities that stem from socially constructed gender roles based on unequal socioeconomic and political power (Moss, 2002;Palència et al, 2014;Dunkle et al, 2004;El-Bassel et al, 2005;El-Bassel et al, 2011).…”

“…People using drugs are a highly stigmatised group (Kulesza et al, 2016;Earnshaw et al, 2013;Room, 2005;Luoma et al, 2007;Lloyd, 2013;Link et al, 1999). Experiencing stigma has been associated with poor adherence to medication, poor help-seeking behaviour and may be associated with sexual health risks (Vanable et al, 2006;Earnshaw and Chaudoir, 2009).…”

Estigma social de profesionales de la salud hacia personas que usan drogas

“…Esta investigación reveló que los profesionales de salud entrevistados estigmatizan a las personas que usan alcohol y drogas, independiente del contexto en el que trabajen; situación que guarda relación con la literatura sobre el tema, la cual reporta que los profesionales sanitarios tienen actitudes estigmatizantes respecto a esta población, debido a las connotaciones morales construidas frente a la práctica del consumo, según las cuales, tanto las sustancias como las personas que las usan son consideradas indeseables (Kulesza et al, 2016;Vásquez, 2009).…”

Addressing Alcohol and Marijuana use Disparities among Latino Adolescents

“…The much lower reported percentage of marijuana use in the present dissertation study may be due to the unique subpopulations of Latinos who live in Miami-Dade County, Florida which is much different from the Latinos throughout the rest of the U.S. The high stigmatizing attitude associated with marijuana use and drug addiction among Latinos may also play a role, and stigmatizing attitudes may differ between Latino subpopulations (Florez et al, 2015;Kulesza et al, 2016). It is possible that the diverse Latino population in Miami-Dade County has stronger stigmatizing attitudes toward marijuana use as compared to Latinos throughout the rest of the U.S.…”

“…Moreover, when the test of differences in deviance between the reduced model (Religion) and the full model (country of birth, Religion, sex) was performed, there were no significant differences between the models. among Latinos, it is not surprising that the Latino adolescents who identified more strongly with being independent and self-reliant, a value that is not traditionally of high value in Latino culture, would be at increased risk of lifetime marijuana use (Florez et al, 2015;Kulesza et al, 2016).…”