Activity 2: Stigma and its impact on treatment accessibility

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Topic Progress:

In this activity, we consider how the stigma that the substance use population experiences impacts their ability to access treatment. Professional and internalized attitudes towards the substance using population cause people with substance use disorders to experience barriers in accessing substance use treatment services. Health care providers’ negative beliefs about people with substance use disorders can include: they overuse system resources, they are not vested in their own health, they abuse the system through drug-seeking behaviours, and they fail to adhere to recommended care (Livingston et al., 2012). Livingston et al. (2012) suggest that these beliefs “can contribute to inequitable and poor provision of care for people with these disorders” (p. 107).

In this activity, the Ross & Goldner (2009) article provides a literature review of nurses’ attitudes and stigma toward people with mental illness. This literature review identifies two themes: (1) nurses as “the stigmatizers” and (2) nurses as “the stigmatized.” Also, the article explores sub-themes within these main categorizes. This review supports “the contention that nurses do play the regrettable roles of the perpetrators and the recipients of stigma towards mental illness” (p. 564). Although this article is about nurses, its themes can be generalized to many other professional groups.

The second part of this activity will consider gender-based stigma. Both the Wechsberg et al. (2008) and the van Olphen et al. (2009) articles highlight the entrenched stigma that women experience (globally) and how the barriers to gender-sensitive treatment remain major obstacles to equitable service accessibility and treatment options.


  1. Read: Ross, C., & Goldner, E. (2009). Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 16(6), 558–567. (available through TRU Library)

    Although this article is specifically about nurses and the stigma associated with mental illness, its ideas may have some generalizability to other professions and substance use. Reflect on how these ideas could be perceived within yourself, and also whether you have seen these ideas reflected in your colleagues.

  2. Read the following articles:
    • Wechsberg, W., Luseno, W., & Ellerson, R. (2008). Reaching women substance abusers in diverse settings: Stigma and Access to Treatment 30 years later. Substance Use and Misuse, 43(8–9), 1277–1279.
    • van Olphen, J., Eliason, M., Freudenberg, N., & Barnes, M. (2009) Nowhere to go: How stigma limits the options of female drug users after release from jail. Substance Abuse Treatment Prevention Policy, 4, 10.
  3. What do you think about gender-based stigma? What are the contributing structural factors? What could you and treatment programs do to reduce gender-based stigma?