This collection addresses one of the most significant issues surrounding the opioid crisis: the sigma faced by people who suffer from addictions.
The National Academies of Science, Engineering, and Medicine defines stigma as a range of negative attitudes, beliefs and behaviors that are associated with certain conditions such as addiction. Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), has been a leading voice in talking about the “chilling effect” stigma has on our ability to address substance use and addiction in our country. In an April 2020 perspective piece published in the New England Journal of Medicine and in her NIDA blog piece, Dr. Volkow explains how stigma can prevent people from seeking care and can even contribute to their continuing addiction. We encourage our visitors to read Dr. Volkow’s writings as well as to familiarize themselves with the efforts to reduce stigma led by the National Institutes of Health (NIH) including the NIH HEAL InitiativeSM, which has made addressing stigma a key element in their efforts to address opioid addiction.
1. We begin this collection of resources with:
- A one-page guide from the Arizona Rethink Rx Abuse campaign that clearly explains why efforts to reduce stigma are so important; and
- A patient brochure from the Veterans Health Administration that uses a question and answer format to combat common myths about opioid use disorder.
2. A collection of resources that explain the importance of using non-stigmatizing language when discussing substance use or working with people with substance use issues – This collection includes a research summary, several infographics, and a link to the Recovery Research Institute’s Addictionary, which provides language patients, providers, and policy makers can use that does not stigmatize and creates a supportive and compassionate treatment and recovery environment.
3. A collection of videos that address the topic of substance related stigma including a training video on stigma reduction for clinicians, videos that highlight the importance of creating supportive and compassionate treatment environments from the perspective of people in recovery, and the videos and public serve announcement from the State Without StigMA campaign created by the Commonwealth of Massachusetts
4. A group of resources that provide guidance for creating stigma reduction campaigns in local communities and examples of existing community programs
5. A link to a free OpenEdX training program for health care providers on reducing stigma from Dell Medical School, University of Texas at Austin
6. Training materials from the Harm Reduction Coalition’s Understanding Drug Related Stigma and a link the Coalition’s webpage to access training exercises
7. A link to a previously published collection specifically about countering stigma against medication assisted treatment for opioid use disorder.
8. Guidance on reducing stigma for specific audiences:
- Clinicians from the Veteran’s Health Administration
- Pharmacists from the College of Psychiatric & Neurologic Pharmacists
- Faith-based organizations from the Morris County, New Jersey Stigma-Free Communities Initiative
- People who use drugs from the Harm Reduction Coalition
If you have additional materials we should consider including in this collection, please see our call for submissions page.
Opioid Use Disorder – A Guide for Stigma Reduction Efforts
Source: Arizona Rethink RX Abuse
This 2 page guide from the ReThink Rx Initiative in Arizona defines stigma and explains why we must address stigma in order to have an impact on the opioid and addiction crisis. It also describes 8 steps individuals and organizations can take to reduces stigma.
Opioids – Do You Know the Truth About Opioid Use Disorder?
Source: Veterans Administration Pharmacy Benefits Management Academic Detailing
This patient brochure from the Veterans Health Administration provides basic information about opioid use disorder and addresses aspects of stigma. It uses a format of posing True or False questions such as: are opioids effective for the long-term management of pain? Is developing opioid use disorder a choice? And is it true that people can never recover from opioid use disorder?
Reducing Stigma Surrounding Substance Use Disorders: The Importance of Language
One of the most important steps we can take to counter stigma surrounding substance use and addiction is to be careful about the language we use. Multiple studies have shown that how we talk about substance use and people who use substances can affect people’s engagement in treatment and achievement of recovery. This collection contains resources that explain the importance of carefully choosing words and provides examples of stigma-free language:
Reducing Stigma Surrounding Substance Use Disorders: Videos
As part of CLOUD’s collection dedicated to reducing the stigma surrounding substance use disorder, we provide several videos that may be used in education or public information campaigns.
Reducing Stigma Surrounding Substance Use Disorders: Creating a Community-based Anti-Stigma Initiative
Reducing the stigma surrounding substance use disorders requires changing people’s attitudes and behaviors, a challenging task many state and local government and community organizations have undertaken. In this collection, we provide guidance on creating your own community anti-stigma campaigns and examples of programs currently in operation across the country.
Reducing Stigma Education Tools (ReSET)
Source: Dell Medical School - University of Texas at Austin
This OpenEdX free training program on reducing stigma is designed for health care providers and includes 2 modules. The first module explains the impact of opioid use disorder stigma on patients and explores the medial model of addiction. The second module emphasizes developing practical tools for addressing stigma and delivering compassionate, recovery-oriented care to patients with opioid use disorder.
Reducing Stigma Surrounding Substance Use Disorders: Harm Reduction Coalition Training Program
The Harm Reduction Coalition (HRC) created the Understanding Drug Related Stigma training program in partnership with the New York State Department of Health’s AIDS Institute. According to HRC, the training objectives include: Understanding the meaning of stigma, discrimination, and related concepts Identifying the various ways drug users experience stigma Exploring key sources of preexisting stigma and discrimination including stereotypes and labels placed on drug users Identifying consequences of drug-related stigma on drug users’ willingness to access services Considering ways to address stigma at individual and agency levels Gaining conceptual and practical tools toward promoting attitudes that challenge stigma and support drug users’ needs
Medication Assisted Treatment – Stigma and Negative Stereotypes
Despite the overwhelming evidence that medications such as methadone, buprenorphine, and naltrexone are effective at treating opioid use disorder, objections to medication assisted treatment (MAT) are still common. The resources in this collection are intended to help dispell the myths and negative stereotypes about MAT.
Opioid Use Disorder – A VA Clinician’s Guide to Identification and Management of Opioid Use Disorder
Source: Veterans Administration Pharmacy Benefits Management Academic Detailing
This clinician’s guide from the Veterans Health Administration discusses opioid use disorder (OUD). It includes sections on the need to reduce stigma, how to use accurate and non-judgmental language, how to identify patients with OUD and determine the severity of their condition, how to engage patients in treatment, and how to provide OUD treatment in a primary care setting.
Harm Reduction Strategies for People Who Inject Drugs: Considerations for Pharmacists
Source: College of Psychiatric & Neurologic Pharmacists
This 2018 publication by the College of Psychiatric and Neurologic Pharmacists presents the concept of harm reduction and presents strategies for pharmacists to adopt harm reduction concepts in their practices.
Stigma-Free Communities Initiative Faith Organization Toolkit
Source: Morris County, New Jersey Stigma-Free Communities Initiative
This toolkit was designed to assist faith-based organizations in creating stigma-free communities. The toolkit includes information about stigma, a sample resolution for organizations to adopt, and information about forming a task force, creating an action plan, and communicating with the press.
Quality Healthcare Is Your Right – A Guide for People Who Use Drugs
Source: Harm Reduction Coalition
This patient education guide was written to help people who use drugs access safe and quality health care. It provides information about the importance of seeking health care when appropriate, provides tips on finding a good health care provider or clinic, how to prepare for healthcare visits,