Understanding and coping with OUD stigma

Opioid use disorder (OUD) is a medical condition characterized by a physical and psychological dependence on opioids, and the chronic use of opioids. This includes the use of both illegal opioid drugs and prescription opioid medications. Opioid use was declared a public health emergency in the United States in 2017 and has resulted in hundreds of thousands of deaths.

While OUD is a widespread public health concern, it is also an intensely personal condition to manage. It affects many different people, it affects everyone differently, and each person with OUD will have unique needs when it comes to treatment.

While everyone’s treatment plan for OUD will incorporate their unique needs, treatment typically includes a combination of counseling and therapy, social support, and medications. Treatment options for OUD have improved over the past decade and continue to improve. However, people with OUD still face many barriers in accessing the care that they need.

One barrier to care for OUD is stigma.

What is stigma?

Stigma is easy to define but it can be difficult to describe. A basic definition of stigma is “a negative or unfair social attitude directed at a person for a specific characteristic or circumstance.” Here, that characteristic or circumstance would be OUD.

Stigma can sometimes be difficult to describe because it can take different forms, it can come from different sources, and it is a different experience for different individuals.

A person may experience stigma from people they know in their personal lives, coworkers and colleagues, and in some cases, from healthcare providers. Stigma often involves negative stereotypes about people with OUD. This leads to people being judged, treated differently, or excluded because of OUD.

On a larger scale, there is structural or institutional stigma. This includes laws and policies that affect how a person with OUD is treated by institutions. For example, insurance policies that discourage medical treatment for OUD or laws that permit discrimination against people with OUD in healthcare settings. These kinds of laws and policies are often driven by underlying social stigmas.

There is also internalized stigma. This occurs when a person with OUD views the stigma they have experienced as valid or justified. This can involve shame, guilt, self-directed anger, embarrassment, and many other negative thoughts and opinions about oneself.

It’s also important to mention that stigma can extend to friends and loved ones of people living with OUD.

Why stigma can be a barrier to care

A barrier to care is anything that prevents a person from seeking appropriate healthcare for a medical condition. Stigma is a significant barrier to care for people with OUD. Many people with OUD avoid or delay treatment due to stigma or the anticipation of stigma. Stigma has also been associated with lower adherence to treatment, which puts a person being treated at a higher risk for relapse, overdose, and other complications.

How a person with OUD can address stigma

If you or a loved one is living with OUD, the number one thing to do is to seek treatment. Treatment for OUD is effective.

If you are experiencing stigma or have experienced stigma in the past, spend some time thinking about your experiences and ways stigma can be addressed. These strategies may help you get started.

• Write down your experiences. For example, examining situations where you’ve felt uncomfortable, embarrassed, or treated differently because of OUD. Think about how these situations affected you and if they affected decisions about treatment.
• Build your support network. This can include friends and loved ones. It can also be helpful to participate in a support group where you can connect with other people who have their own experiences with OUD.
• Keep learning about OUD. Misinformation is a major contributing factor to stigma. Learning about what causes OUD and how it can be treated can prepare you to have conversations about the condition when you need to.
• Be honest with your healthcare provider. OUD is a medical condition that requires treatment. It’s also a condition that can be difficult to talk about, even in healthcare settings. Remember, in order to provide you with the best care possible, your healthcare provider needs honesty.

As mentioned above, counseling and therapy are significant parts of most treatment plans for OUD. The mental health professionals you are working with should be familiar with stigma and how it affects people with OUD, and they can be a valuable source of support and strategies for addressing stigma in your life.

Also mentioned above, stigma can and does occur in healthcare settings. If you’ve faced stigma in a healthcare setting, consider looking for a different healthcare provider, one who has experience treating substance use disorders like OUD, who approaches treatment with compassion and understanding.