Lesson 10 Summary

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Topic Progress:

In this lesson, we broadened our perspective and understanding about the insidiousness of stigma in all aspects of substance use services. We considered the issues of self-stigma (the substance user’s perception of shame), social stigma (the general prejudices in society about people with substance use disorders), and structural stigma (from health professionals and within program processes). In particular, gender-based stigma was considered along with the enhanced stigma that people in smaller communities may experience when accessing services. The literature we reviewed indicated that stigma is a significant factor for people accessing and completing treatment services.

Although touched on in this lesson, the next lesson will focus more on strategies that can be used to reduce the stigma of substance use and substance use disorders.


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Livingston , J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction, 107(1), 39–50.

National Treatment Strategy Working Group (2008). A systems approach to substance use in Canada: Recommendations for a national treatment strategy. Ottawa: National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada.

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.

Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug Alcohol Review, 24, 143–155.

Ross, C., & Goldner, E. (2009). Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature., 16(6), 558–567.

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.

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.