Difference between revisions of "Reduce Stigma"
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| − | <div | + | <div class="mw-parser-output"><div class="mw-parser-output"><div class="wiki" id="content_view" style="display: block">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] <div id="toc"> |
| − | + | = Table of Contents = | |
| − | + | <div style="margin-left: 1em">[[#Background|Background]]</div> <div style="margin-left: 1em">[[#Current_Status|Current Status]]</div> <div style="margin-left: 1em">[[#Social_Factors_.26_Participation_in_Treatment_Programs|Social Factors & Participation in Treatment Programs]]</div> <div style="margin-left: 2em">[[#Social_Factors_.26_Participation_in_Treatment_Programs-Stigma_Around_Addiction_Treatment|Stigma Around Addiction Treatment]]</div> <div style="margin-left: 1em">[[#Use_Person-Centric_Language|Use Person-Centric Language]]</div> <div style="margin-left: 1em">[[#Tools_.26_Resources|Tools & Resources]]</div> <div style="margin-left: 1em">[[#Scorecard_Building|Scorecard Building]]</div> <div style="margin-left: 1em">[[#Resources_to_Investigate|Resources to Investigate]]</div> <div style="margin-left: 1em">[[#Sources|Sources]]</div> </div> | |
| − | Return to [[Opioid Top-Level Strategy Map]] | + | = Background = |
| − | =Table of Contents= | ||
| − | <div style="margin-left: 1em">[[#Background|Background]]</div><div style="margin-left: 1em">[[# | ||
| − | =Background= | ||
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| − | * Call it what it is: substance use disorder (or alcohol use disorder, cocaine use disorder, etc.) or substance dependence (or alcohol dependence, drug dependence, etc.). In a non-clinical environment, addiction is also acceptable. | + | Recent research showed that substance use is more stigmatized than obesity and smoking tobacco.<sup class="reference">[1]</sup> |
| − | * Use "people first" language and refer to people with substance use disorder, people with drug dependence, people with addiction. | + | |
| − | ** The new edition of the Associated Press style book recommends people first phrasing with the goal of separating the person from the disease. | + | '''Self-stigma''': Shame, evaluative thoughts, and fear of enacted stigma -- prevents users from seeking prevention services, testing and treatment. Stigma also limits employment, school enrollment, housing and access to social and safety net services for users.<sup class="reference">[2]</sup><sup class="reference">[3]</sup> |
| − | * Avoid negative terms like addict, junkie, wino, boozer, drug fiend, and bum. | + | |
| − | =Social Factors & Participation in Treatment Programs= | + | <span style="background-color: #ffffff">Studies have shown that people with substance use disorder experience labeling, shame, and rejection from family members, friends, teachers, co-workers, supervisors, and health care professionals. This stigma can get in the way of the support that people in recovery --and early recovery especially -- need. Outside stigma can become internalized, leading people in recovery to embody and adopt inaccurate beliefs about themselves due to their exposure to external stigmatizing forces.<sup class="reference">[4]</sup> |
| − | <span style="background-color: #ffffff">Individual and Social Factors Associated With Participation in Treatment Programs for Drug Users</span><br /> <span style="background-color: #ffffff"> Research conducted by: V. Anna Gyarmathy and Carl A. Latkin</span><br /> <br /> <span style="background-color: #ffffff"> The purpose of the research project was to establish a clear connection between the effect of positive social influence and the number of recovering addicts seeking treatment. The research team worked </span><br /> <span style="background-color: #ffffff"> to identify factors that impede or facilitate treatment participation. <span style="background-color: #ffffff">Based on this analysis, they concluded that social influence may not only promote entry into treatment but also the success of treatment results.</span></span><br /> <br /> <span style="background-color: #ffffff"> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626660/ Click here to read academic article.]</span>< | + | |
| − | ==Stigma Around Addiction Treatment== | + | </span> |
| − | <span style="background-color: #ffffff">Due to a high volume of treatment centers more focused on profit than patients, a certain stigma has developed around seeking treatment. Certain practices, however, can be seen as red flags for these unscrupulous treatment centers. Educate users seeking treatment as well as people who do patient referrals about these signs to avoid sending patients to these types of treatment centers. </span><br /> <span style="background-color: #ffffff"> '''Causes of Addiction Treatment Stigma'''</span><br /> | + | |
| + | | ||
| + | |||
| + | = <span style="background-color: #ffffff">Current Status</span> = | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff">A 2014 literature review of programs for reducing stigma found that online education programs and face-to-face education programs were equally effective in reducing personal stigma (an individual's own attitude towards people with mental illness), but neither was effective in reducing self-stigma.<sup class="reference">[5]</sup> Other research has shown that therapeutic interventions such as group-based Acceptance and Commitment Therapy (ACT) and vocational counseling produce positive outcomes for substance users suffering from self-stigma.<sup class="reference">[6]</sup><br/> <br/> <span style="background-color: #ffffff">Some suggestions for stigma-reducing language:<sup class="reference">[7]</sup></span></span></span> | ||
| + | |||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Call it what it is: substance use disorder (or alcohol use disorder, cocaine use disorder, etc.) or substance dependence (or alcohol dependence, drug dependence, etc.). In a non-clinical environment, addiction is also acceptable.</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Use "people first" language and refer to people with substance use disorder, people with drug dependence, people with addiction.</span></span></span> | ||
| + | **<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">The new edition of the Associated Press style book recommends people first phrasing with the goal of separating the person from the disease.</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Avoid negative terms like addict, junkie, wino, boozer, drug fiend, and bum.</span></span></span> | ||
| + | |||
| + | | ||
| + | |||
| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Social Factors & Participation in Treatment Programs</span></span></span> = | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Individual and Social Factors Associated With Participation in Treatment Programs for Drug Users</span><br/> <span style="background-color: #ffffff">Research conducted by: V. Anna Gyarmathy and Carl A. Latkin</span><br/> <br/> <span style="background-color: #ffffff">The purpose of the research project was to establish a clear connection between the effect of positive social influence and the number of recovering addicts seeking treatment. The research team worked </span><br/> <span style="background-color: #ffffff">to identify factors that impede or facilitate treatment participation. <span style="background-color: #ffffff">Based on this analysis, they concluded that social influence may not only promote entry into treatment but also the success of treatment results.</span></span><br/> <br/> <span style="background-color: #ffffff">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626660/ Click here to read academic article.]</span></span></span></span> | ||
| + | |||
| + | == <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Stigma Around Addiction Treatment</span></span></span> == | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Due to a high volume of treatment centers more focused on profit than patients, a certain stigma has developed around seeking treatment. Certain practices, however, can be seen as red flags for these unscrupulous treatment centers. Educate users seeking treatment as well as people who do patient referrals about these signs to avoid sending patients to these types of treatment centers. </span><br/> <span style="background-color: #ffffff">'''Causes of Addiction Treatment Stigma'''</span></span></span></span> | ||
| + | |||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">The High Number of Arrests for Drug Possession in the United States</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Patient Brokering</span></span></span> | ||
| + | **<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">This illegal practice occurs when "body brokers" make money by recruiting addicts for unethical and unscrupulous treatment facilities</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Rampant Urinalysis Testing and Lab Abuse</span></span></span> | ||
| + | **<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Some sober homes around the country have found a way to make money by recruiting people for the intensive outpatient programs (IOPs) that take place at drug rehab centers. These centers charge millions of dollars in fees to insurance companies for drug urinalysis performed on patients in IOPs.</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Unbranded Drug Rehab Websites</span></span></span> | ||
| + | **<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Some facilities have created unbranded websites to attract additional web traffic. These websites often try to appear like an independent source verifying that one rehab center may be better than another, when in reality that website was created by a rehab center.</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Lack of Outcomes Data</span></span></span> | ||
| + | **<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">The measure of substance use disorder treatment effectiveness may be more nuanced than presented by the treatment center's website. For example, if a center says it has a 90% success rate, that most likely refers to the following conditions</span></span></span> | ||
| + | ***<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">A reduction in the frequency of substance use ''during'' drug rehab treatment</span></span></span> | ||
| + | ***<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">A reduction in the amount of the substance being used ''during'' drug rehab treatment</span></span></span> | ||
| + | ***<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Successful sobriety for a relative period of time (i.e. self-reported sobriety among patients between 3 and 6 months after treatment)</span></span></span> | ||
| + | *<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Drug Rehab Centers: Some Claim to Be Experts at Everything</span></span></span> | ||
| + | |||
| + | | ||
| + | |||
| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Use Person-Centric Language</span></span></span> = | ||
| + | |||
| + | | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Those writing about mental health and addiction should strongly consider the language they use when describing those struggling with those issues. [https://en.wikipedia.org/wiki/People-first_language People-first language] or person-centric language can influence whether the material produced is further stigmatizing to people. See [[TR_-_Reduce_Stigma_of_Seeking_Help_for_Substance_Misuse|Tools & Resources]] for a guide to using person centric language. | ||
| + | |||
| + | </span></span></span> | ||
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| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Tools & Resources</span></span></span> = | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[[TR_-_Reduce_Stigma_of_Seeking_Help_for_Substance_Misuse|TR - Reduce Stigma of Seeking Help for Substance Misuse]]</span></span></span></span> | ||
| + | |||
| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Scorecard Building</span></span></span> = | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[[PO_-_Reduce_Stigma_of_Seeking_Help_for_Substance_Misuse|Potential Objective Details]]</span><br/> <span style="background-color: #ffffff">[[PM_-_Reduce_Stigma_of_Seeking_Help_for_Substance_Misuse|Potential Measures and Data Sources]]</span><br/> <span style="background-color: #ffffff">[[PA_-_Reduce_Stigma_of_Seeking_Help_for_Substance_Misuse|Potential Actions and Partners]]</span></span></span></span> | ||
| + | |||
| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Resources to Investigate</span></span></span> = | ||
| + | |||
| + | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[[RTI_-_Stigma_&_Substance_Misuse|More RTI on Stigma and Substance Misuse]]</span><br/> <br/> <span style="background-color: #ffffff"><span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span></span><br/> <span style="background-color: #ffffff"><span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span></span></span></span></span> | ||
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| − | | < | + | | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">'''Reviewer'''</span></span></span> |
| − | | < | + | | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">'''Date'''</span></span></span> |
| − | | < | + | | <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">'''Comments'''</span></span></span> |
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|} | |} | ||
| − | =Sources= | + | |
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| + | = <span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">Sources</span></span></span> = | ||
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---- | ---- | ||
| − | # [http://www.tandfonline.com/doi/abs/10.3109/14659891.2012.661516 Substance use more stigmatized than smoking and obesity]<br /> <span class="entryAuthor">Lindsay A. Phillips and Autherine Shaw</span><br /> <span class="journalName">[http://www.tandfonline.com/toc/ijsu20/18/4 Journal Of Substance Use]</span> <span class="volume">Vol. 18 , Iss. 4,2013</span>[http://www.tandfonline.com/doi/abs/10.3109/14659891.2012.661516] | + | |
| − | # [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064952/] | + | |
| − | # [http://nacchopreparedness.org/opioid-associated-outbreaks-preparation-prevention-lessons-from-the-indiana-hivhcv-outbreak-among-people-who-inject-drugs/] | + | #<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[http://www.tandfonline.com/doi/abs/10.3109/14659891.2012.661516 Substance use more stigmatized than smoking and obesity]<br/> <span class="entryAuthor">Lindsay A. Phillips and Autherine Shaw</span><br/> <span class="journalName">[http://www.tandfonline.com/toc/ijsu20/18/4 Journal Of Substance Use]</span> <span class="volume">Vol. 18 , Iss. 4,2013</span>[http://www.tandfonline.com/doi/abs/10.3109/14659891.2012.661516 [1]]</span></span></span> |
| − | # | + | #<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064952/ [2]]</span></span></span> |
| − | </ | + | #<span style="background-color: #ffffff"><span style="background-color: #ffffff"><span style="background-color: #ffffff">[http://nacchopreparedness.org/opioid-associated-outbreaks-preparation-prevention-lessons-from-the-indiana-hivhcv-outbreak-among-people-who-inject-drugs/ [3]]</span></span></span> |
| + | # | ||
| + | |||
| + | <br/> <br/> <span style="background-color: #ffffff"><span style="background-color: #ffffff">[http://www.attcnetwork.org/regcenters/productDocs/2/Anti-Stigma%20Toolkit.pdf [4]]</span></span> | ||
| + | |||
| + | * | ||
| − | + | <br/> <br/> <span style="background-color: #ffffff">Griffiths, Kathleen M et al. “Effectiveness of Programs for Reducing the Stigma Associated with Mental Disorders. A Meta-Analysis of Randomized Controlled Trials.” ''World Psychiatry'' 13.2 (2014): 161–175. ''PMC''. Web. 13 Jan. 2017.<br/> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102289/ [5]]</span> | |
| − | </ | ||
| − | * Livingston, James D et al. “The Effectiveness of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review.” ''Addiction (Abingdon, England)'' 107.1 (2012): 39–50. ''PMC''. Web. 10 Jan. 2017.<br /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272222/] | + | *<span style="background-color: #ffffff">Livingston, James D et al. “The Effectiveness of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review.” ''Addiction (Abingdon, England)'' 107.1 (2012): 39–50. ''PMC''. Web. 10 Jan. 2017.<br/> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272222/ [6]]</span> |
| − | + | * | |
| − | </span><br /> <br /> [http://smartapproaches.bangordailynews.com/2015/12/04/recovery/social-stigma-and-substance-use-why-language-matters/]</div> | + | <br/> <br/> [http://smartapproaches.bangordailynews.com/2015/12/04/recovery/social-stigma-and-substance-use-why-language-matters/ [7]]</div> </div> </div> |
Revision as of 06:50, 11 January 2019
Return to Opioid Top-Level Strategy Map
[7]
Contents
Table of Contents
Background
Recent research showed that substance use is more stigmatized than obesity and smoking tobacco.[1]
Self-stigma: Shame, evaluative thoughts, and fear of enacted stigma -- prevents users from seeking prevention services, testing and treatment. Stigma also limits employment, school enrollment, housing and access to social and safety net services for users.[2][3]
Studies have shown that people with substance use disorder experience labeling, shame, and rejection from family members, friends, teachers, co-workers, supervisors, and health care professionals. This stigma can get in the way of the support that people in recovery --and early recovery especially -- need. Outside stigma can become internalized, leading people in recovery to embody and adopt inaccurate beliefs about themselves due to their exposure to external stigmatizing forces.[4]
Current Status
A 2014 literature review of programs for reducing stigma found that online education programs and face-to-face education programs were equally effective in reducing personal stigma (an individual's own attitude towards people with mental illness), but neither was effective in reducing self-stigma.[5] Other research has shown that therapeutic interventions such as group-based Acceptance and Commitment Therapy (ACT) and vocational counseling produce positive outcomes for substance users suffering from self-stigma.[6]
Some suggestions for stigma-reducing language:[7]
- Call it what it is: substance use disorder (or alcohol use disorder, cocaine use disorder, etc.) or substance dependence (or alcohol dependence, drug dependence, etc.). In a non-clinical environment, addiction is also acceptable.
- Use "people first" language and refer to people with substance use disorder, people with drug dependence, people with addiction.
- The new edition of the Associated Press style book recommends people first phrasing with the goal of separating the person from the disease.
- Avoid negative terms like addict, junkie, wino, boozer, drug fiend, and bum.
Social Factors & Participation in Treatment Programs
Individual and Social Factors Associated With Participation in Treatment Programs for Drug Users
Research conducted by: V. Anna Gyarmathy and Carl A. Latkin
The purpose of the research project was to establish a clear connection between the effect of positive social influence and the number of recovering addicts seeking treatment. The research team worked
to identify factors that impede or facilitate treatment participation. Based on this analysis, they concluded that social influence may not only promote entry into treatment but also the success of treatment results.
Click here to read academic article.
Stigma Around Addiction Treatment
Due to a high volume of treatment centers more focused on profit than patients, a certain stigma has developed around seeking treatment. Certain practices, however, can be seen as red flags for these unscrupulous treatment centers. Educate users seeking treatment as well as people who do patient referrals about these signs to avoid sending patients to these types of treatment centers.
Causes of Addiction Treatment Stigma
- The High Number of Arrests for Drug Possession in the United States
- Patient Brokering
- This illegal practice occurs when "body brokers" make money by recruiting addicts for unethical and unscrupulous treatment facilities
- Rampant Urinalysis Testing and Lab Abuse
- Some sober homes around the country have found a way to make money by recruiting people for the intensive outpatient programs (IOPs) that take place at drug rehab centers. These centers charge millions of dollars in fees to insurance companies for drug urinalysis performed on patients in IOPs.
- Unbranded Drug Rehab Websites
- Some facilities have created unbranded websites to attract additional web traffic. These websites often try to appear like an independent source verifying that one rehab center may be better than another, when in reality that website was created by a rehab center.
- Lack of Outcomes Data
- The measure of substance use disorder treatment effectiveness may be more nuanced than presented by the treatment center's website. For example, if a center says it has a 90% success rate, that most likely refers to the following conditions
- A reduction in the frequency of substance use during drug rehab treatment
- A reduction in the amount of the substance being used during drug rehab treatment
- Successful sobriety for a relative period of time (i.e. self-reported sobriety among patients between 3 and 6 months after treatment)
- The measure of substance use disorder treatment effectiveness may be more nuanced than presented by the treatment center's website. For example, if a center says it has a 90% success rate, that most likely refers to the following conditions
- Drug Rehab Centers: Some Claim to Be Experts at Everything
Use Person-Centric Language
Those writing about mental health and addiction should strongly consider the language they use when describing those struggling with those issues. People-first language or person-centric language can influence whether the material produced is further stigmatizing to people. See Tools & Resources for a guide to using person centric language.
Tools & Resources
TR - Reduce Stigma of Seeking Help for Substance Misuse
Scorecard Building
Potential Objective Details
Potential Measures and Data Sources
Potential Actions and Partners
Resources to Investigate
More RTI on Stigma and Substance Misuse
PAGE MANAGER: [insert name here]
SUBJECT MATTER EXPERT: [fill out table below]
| Reviewer | Date | Comments |
Sources
- Substance use more stigmatized than smoking and obesity
Lindsay A. Phillips and Autherine Shaw
Journal Of Substance Use Vol. 18 , Iss. 4,2013[1] - [2]
- [3]
[4]
Griffiths, Kathleen M et al. “Effectiveness of Programs for Reducing the Stigma Associated with Mental Disorders. A Meta-Analysis of Randomized Controlled Trials.” World Psychiatry 13.2 (2014): 161–175. PMC. Web. 13 Jan. 2017.
[5]
- Livingston, James D et al. “The Effectiveness of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review.” Addiction (Abingdon, England) 107.1 (2012): 39–50. PMC. Web. 10 Jan. 2017.
[6]
[7]
