Stigma among Individuals with Substance Use Disorders: Does it Predict Substance Use, and Does it Diminish with Treatment?

Abstract

Aims: Drug and alcohol use-related stigma affects employment, physical and mental health, and has been shown to be a barrier to seeking treatment. Thus, the need to address stigma in substance use disorders treatment has been noted in the clinical literature. We aimed to examine whether stigma is related to alcohol/substance use as well as whether treatment as usual for substance use disorders affects stigma, depressive symptoms, and quality of life.

Methods: Participants were individuals attending intensive outpatient treatment for substance use disorders. Baseline sample consisted of 17 Caucasian, predominantly male (i.e. 65%) participants, averaging 34.06 years of age. At post-treatment and one month follow-up assessments there were 12 and 7 participants respectively.

Results: Higher post-treatment stigma was significantly related to a greater number of drug use days at follow-up. We did not find significant differences between baseline, post-treatment and follow-up assessment on self-stigma. However, participants reported a significant decrease in symptoms of depression from baseline to post-treatment and a significant increase in these symptoms between post-treatment and follow-up.

Conclusions: Our results suggest that stigma may have a detrimental impact on substance use. Also, while depressive symptoms may improve as a result of treatment as usual for substance use disorders, symptoms of depression may worsen shortly after treatment. These results highlight the need for more work on these relationships due to the very preliminary nature of these findings.

Keywords: Stigma; Substance use disorders; Treatment.