Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;75(9):1300-1311.
doi: 10.1037/amp0000744.

Stigma and substance use disorders: A clinical, research, and advocacy agenda

Valerie A Earnshaw  1
Affiliations

Stigma and substance use disorders: A clinical, research, and advocacy agenda

Valerie A Earnshaw. Am Psychol. 2020 Dec.

Abstract

The United States is currently experiencing an opioid epidemic, with deaths due to opioid overdoses persisting in many communities. This epidemic is the latest wave in a series of global substance use-related public health crises. As a fundamental cause of health inequities, stigma leads to the development of substance use disorders (SUDs), undermines SUD treatment efforts, and drives persistent disparities within these crises. Given their expertise in mental and behavioral health, psychologists are uniquely positioned to play a frontline role in addressing SUD stigma. The goal of this paper is to set an agenda for psychologists to address SUD stigma through clinical care, research, and advocacy. To set the stage for this agenda, key concepts are introduced related to stigma and SUDs, and evidence is reviewed regarding associations between stigma and substance use-related outcomes. As clinicians, psychologists have opportunities to promote resilience to stigma to prevent the development of SUDs, and leverage acceptance and mindfulness approaches to reduce internalized stigma among people with SUDs. As researchers, psychologists can clarify the experiences and impacts of stigma among people with SUDs over time and adapt the stigma-reduction toolbox to address SUD stigma. As advocates, psychologists can call for changes in structural stigma such as policies that criminalize people with SUDs, protest the intentional use of SUD stigma, and adopt stigma-free language in professional and social settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Substance Use Stigma Framework
Note: *Medication and medication initiation as applicable to the specific SUD
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Barry CL, Sherman SG, & McGinty EE (2018). Language matters in combatting the opioid epidemic: Safe consumption sites versus overdose prevention sites. American Journal of Public Health, 108(9), 1157–1159. 10.2105/AJPH.2018.304588 - DOI - PMC - PubMed
    1. Bayer R (2008). Stigma and the ethics of public health: Not can we but should we. Social Science & Medicine, 67, 463–472. 10.1016/j.socscimed.2008.03.017 - DOI - PubMed
    1. Bell K, Salmon A, Bowers M, Bell J, & Mccullough L (2010). Smoking, stigma and tobacco ‘denormalization’: Further reflections on the use of stigma as a public health tool. Social Science & Medicine, 70(6), 795–799. 10.1016/j.socscimed.2009.09.060 - DOI - PubMed
    1. Bigler RS, & Liben LS (2013). Developmental theory explaining prejudice intergroup and reducing children’s social stereotyping and prejudice. Current Directions in Psychological Science, 16(3), 162–166.
    1. Birbeck GL, Bond V, Earnshaw VA., & El-nasoor ML (2019). Advancing health equity through cross- cutting approaches to health-related stigma. BMC Medicine, 17(40), 1–5. - PMC - PubMed

Publication types