Activity 3: Stigma and the treatment processes

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Activity 3: Stigma and the treatment processes


Contemporaneous with the stigma that acts as a barrier to substance use treatment services is the stigma associated with treatment that affects both the substance user’s perception of treatment and treatment outcomes. The first article by Radcliffe and Stevens (2008) is a qualitative study conducted in the UK that interviewed substance users who dropped out of treatment programs. In this study, many of the participants said that the experience of drug treatment was stigmatizing, and for some, this was the reason they disengaged from, and dropped out of, services. The final article in this lesson by Keyes et al. (2010) ties together the importance of the therapeutic relationship, the perceptions of staff discrimination, and treatment completion. Read the article to see what the evidence says about the importance of this relationship.


  1. Read the following articles:
    • Radcliffe, P., & Stevens, A. (2008). Are drug treatment services only for “thieving junkie scumbags”? Drug users and the management of stigmatised identities. Social Science & Medicine, 67(7), 1065–1073.
    • Keyes, K., Hatzenbuehler, M., McLaughlin, K., Link, B, Olfson, M., Grant, B., & Hasin, D. (2010). Stigma and treatment for alcohol disorders in the United States. American Journal of Epidemiology, 172(12), 1364–1372.
    • Brener, L., von Hippel, W., von Hippel, C., Resnick, I., & Treloar, C. (2010). Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: Utility of a mixed methods approach. Drug Alcohol Review, 29, 491–497.
  2. One of the fears that people have related to seeking substance use treatment services is that they feel ashamed of themselves for having to use such services (self-stigma); however, another issue related to structural stigma is related to the fear that they will be seen using drug treatment services. This is a particular issue is smaller, remote communities in Canada. How can this barrier be removed in smaller communities? Take the time to post your ideas to the discussion area entitled “Smaller Communities.” You may want to read what others have posted and comment or ask questions.
  3. For those of you who work in detox facilities or organizations that dispense medication, are the processes potentially stigmatizing? Could the processes be changed to reduce or eliminate stigma? If you are not directly involved with medication dispensation, visit a local pharmacy that dispenses methadone. Are their processes potentially stigmatizing?