Reducing Opioid and Substance Use-Related Stigma in Health-Care and Other Direct Service Delivery Contexts

Introduction

This report shares the Mental Health Commission of Canada’s exploration of how to reduce opioid‑related stigma in the context of the opioid crisis. It will summarize activities to date, share results from the initial evaluation of four stigma reduction initiatives, describe emerging themes and lessons, and identify future directions for this work.

Stigma and the opioid crisis
Stigma has been identified as a major barrier to access, care, and recovery for persons experiencing problematic substance use. It has also been identified as a partly destructive force in Canada’s current opioid crisis. The challenges of this crisis — including the negative impacts of stigma on the quality of front‑line care and response — have generated a need to find promising interventions and approaches that can help reduce stigma toward persons living with opioid use and/or who are at risk of opioid-related overdose and poisoning.

It has been well established that the public holds stigmatizing views toward individuals who use substances. However, people who use opioids must also contend with the additional stigma of medication maintenance therapy, despite it being recognized as a best practice in opioid addiction treatment. There is also a lack of acknowledgment that many individuals with opioid use problems developed their conditions due to overprescribing by physicians. The negative attitudes and beliefs associated with the use of opioids manifest themselves both in interactions with the public and with health‑care providers (HCPs) and first responders (FRs). HCP and FR stigma increases barriers to care and reduces the quality of services received by those who use opioids. People seeking or accessing treatment for an opioid use disorder have described feeling degraded, dismissed, and devalued when interacting with HCPs and FRs.

 

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