A pilot study examining perceived rejection and secrecy in relation to illicit drug use and associated stigma

Abstract

Introduction and aims: Illicit drug use is a stigmatised behaviour; therefore, users tend to experience rejection and remain secretive about use. However, stigma-related rejection and secrecy can adversely affect those who reject abstinence. This study aimed to modify measures to assess these concepts with regard to illicit drug use and examine how they relate to use of various drugs and associated perception of public stigma.

Design and methods: An Internet-based convenience sample (n = 700) was surveyed to pilot items modified from previous scales in order to assess these concepts with regard to drug use. As perceived rejection and secrecy are related and potentially overlapping constructs, exploratory factor analysis was conducted to examine the underlying structure of items previously used to assess these concepts. These variables were examined in relation to sociodemographic characteristics, perceived public stigma and use of various drugs (marijuana, powder cocaine, ecstasy and nonmedical use of opioids and prescription stimulants).

Results: After factor reduction, perceived rejection and secrecy loaded as two distinct, but related concepts. These modified measures had moderate to high internal consistency and both concepts were positively related to perceived public stigma and use of various drugs.

Discussion and conclusions: This pilot study demonstrated validity evidence for these measures and results suggest that illicit drug use and associated stigma are related to increased feelings of rejection and secrecy in users. Research is needed to examine whether stigma towards users serves as a deterrent to use because rejection and secrecy are associated with adverse psychosocial outcomes.