Stigma

Stigma affects everyone. Ending the stigma toward people experiencing addiction is more important now than ever, as the rates of substance use disorder and mental health concerns have risen dramatically during the COVID-19 pandemic.¹ Social distancing measures have introduced additional barriers to receiving care for substance use and mental health concerns.

What does “stigma” mean?  

A stigma is a negative assumption about a person, or a group of people, based on a specific belief or behavior.² A stigma can affect how someone is treated by society. Patients with opioid use disorder, or OUD, are often stigmatized, despite OUD being a medical disease that patients do not choose to have. Stigma may also be compounded by other types of bias, such racial, gender, religious, age, and economic biases, further worsening experience and access to care. 

How does stigma affect healthcare? 

Due to the stigma surrounding opioid use, there are negative assumptions about patients with opioid use disorder.² Consequently, it can be difficult for people, including healthcare workers, to recognize OUD as a medical condition that requires treatment just like high blood pressure, heart disease, or diabetes. It is important for healthcare providers to recognize risk factors for OUD and symptoms of OUD so patients can receive appropriate medical treatment.  

Did you know OUD is a disease?

OUD is a chronic medical disease that is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and requires ongoing medical treatment from a physician.^3,4 There are genetic and environmental risks to developing OUD, just like with heart disease, cancer, and diabetes. Similarly, OUD, like many other medical conditions, can be treated with medications, therapies, and lifestyle changes.  

What can we do to reduce the stigma related to opioid use?  

• Be kind and compassionate toward patients with OUD. OUD is just like any other chronic medical disease requiring lifelong treatment. 
• If you have OUD, be kind and compassionate toward yourself. 
• Do your part to reduce stigma toward OUD: 
  • • • Be an advocate and use language to minimize stigma
      • Use the right words to minimize stigma
      • Provide support and encouragement 
      • Be empathetic 
      • Learn more about OUD 

How we talk about opioid misuse and substance use can add to the stigma surrounding OUD.^5,6 It’s important to use language that emphasizes that OUD is a medical disease, not a life choice.⁴ While there are many examples of words to use and words to avoid when talking about OUD, here are some common words and phrases to consider:

Check out Shatterproof’s Addiction Language Guide and Words Matter Video. Learn more about how to approach patients who may be at risk for SUD, screening tools, provider-patient conversation starters, and other SUD care resources on OPEN’s SUD Care Coordination website.

OPEN is dedicated to reducing stigma in our community, focusing on the health care setting. Addressing stigma is a critical aspect of each OPEN initiative. OPEN is excited to collaborate with Shatterproof, a leading stigma reduction nonprofit, in delivering programming that spreads awareness to the importance of patient-centered care and person-first language.

The partnership between OPEN and Shatterproof aims to start conversations on the issue of structural stigma and provides stigma-reduction resources and programming to health care professionals.

OPEN is continuously working behind the scenes to provide the very best care. We are striving to change the trajectory of the opioid epidemic.

We are excited to announce we have taken the Superior Health Quality Alliance Shine a Light on Stigma pledge to support efforts to change the stigma around substance use disorder by encouraging person-first and person-centered language. We are committed to removing the stigma around addiction to increase respect for and dignity of persons with substance use disorder improve care for them—and the families who love them. Join us! Stand up against SUD stigma and receive your pledge certificate.

1. Wu, T., Jia, X., Shi, H., Niu, J., Yin, X., Xie, J., & Wang, X. (2021). Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders, 281, 91-98. https://dx.doi.org/10.1016/j.jad.2020.11.117
2. Tsai, A.C., Kiang, M.V., Barnett, M.L., Beletsky, L., Keyes, K.M., McGinty, E.E., Smith, L.R., Strathdee, S.A., Wakeman, S.E., & Venkataramani, A.S. (2019). Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Medicine, 16(11), 1-18. https://dx.doi.org/10.1371/journal.pmed.1002969
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
4. Murphy, B. (2018, September 13). 4 factors that add to stigma surrounding opioid-use disorder. American Medical Association. https://www.ama-assn.org/delivering-care/overdose-epidemic/4-factors-add-stigma-surrounding-opioid-use-disorder
5. National Institutes of Health. (2021, November 29). Words matter – Terms to use and avoid when talking about addiction. National Institute on Drug Abuse: Advancing Addiction Science. https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction
6. Northwest Portland Area Indian Health Board. (n.d.). Words matter when we talk about addiction. Tribal Opioid Response: Healing our Nations Together. https://www.npaihb.org/wp-content/uploads/2020/07/Words-Matter-When-We-Talk-About-Addiction-For-Patients-Fact-Sheet-21.pdf
7. Torres-Lockhart, K.E., Lu, T.Y., Weimer, M.B., Stein, M.R., & Cunningham, C.O. (2022). Clinical management of opioid withdrawal. Addiction, 117, 2540-2550. https://dx.doi.org/10.1111/add.15818