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      Stigma as a fundamental hindrance to the United States opioid overdose crisis response

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis.

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          Most cited references161

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          Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review.

          Leonieke C van Boekel, Evelien Brouwers, Jaap van Weeghel … (2013)
          Healthcare professionals are crucial in the identification and accessibility to treatment for people with substance use disorders. Our objective was to assess health professionals' attitudes towards patients with substance use disorders and examine the consequences of these attitudes on healthcare delivery for these patients in Western countries. Pubmed, PsycINFO and Embase were systematically searched for articles published between 2000 and 2011. Studies evaluating health professionals' attitudes towards patients with substance use disorders and consequences of negative attitudes were included. An inclusion criterion was that studies addressed alcohol or illicit drug abuse. Reviews, commentaries and letters were excluded, as were studies originating from non-Western countries. The search process yielded 1562 citations. After selection and quality assessment, 28 studies were included. Health professionals generally had a negative attitude towards patients with substance use disorders. They perceived violence, manipulation, and poor motivation as impeding factors in the healthcare delivery for these patients. Health professionals also lacked adequate education, training and support structures in working with this patient group. Negative attitudes of health professionals diminished patients' feelings of empowerment and subsequent treatment outcomes. Health professionals are less involved and have a more task-oriented approach in the delivery of healthcare, resulting in less personal engagement and diminished empathy. This review indicates that negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients. However, few studies have evaluated the consequences of health professionals' negative attitudes towards patients with substance use disorders. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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            A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment

            Bruce G. Link, Francis T. Cullen, Elmer Struening … (1989)
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              Understanding Labeling Effects in the Area of Mental Disorders: An Assessment of the Effects of Expectations of Rejection

              Bruce G. Link (1987)
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                Author and article information

                Journal
                Journal ID (nlm-ta): PLoS Med
                Journal ID (iso-abbrev): PLoS Med
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosmed
                Title: PLoS Medicine
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Print): 1549-1277
                ISSN (Electronic): 1549-1676
                Publication date (Electronic): 26 November 2019
                Publication date Collection: November 2019
                Volume: 16
                Issue: 11
                Electronic Location Identifier: e1002969
                Affiliations
                [1 ] Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
                [2 ] Harvard Medical School, Boston, Massachusetts, United States of America
                [3 ] Mbarara University of Science and Technology, Mbarara, Uganda
                [4 ] Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, United States of America
                [5 ] Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
                [6 ] Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
                [7 ] Northeastern University School of Law, Boston, Massachusetts, United States of America
                [8 ] Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America
                [9 ] Division of Infectious Diseases and Global Public Health, University of California at San Diego School of Medicine, San Diego, California, United States of America
                [10 ] Mailman School of Public Health, Columbia University, New York City, New York, United States of America
                [11 ] Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
                [12 ] Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
                [13 ] Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
                [14 ] Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
                Author notes

                The authors of this manuscript have read the journal's policy and have the following competing interests: ACT receives a stipend as a Specialty Consulting Editor for PLOS Medicine and serves on the journal’s Editorial Board. ACT and SS are Guest Editors for the PLOS Medicine Special Issue on Substance Use, Misuse and Dependence. MLB has been retained as an expert witness in litigation against opioid manufacturers. SEW has received research funding from Optum Labs for a study using Optum claims data to evaluate the comparative effectiveness of different treatment pathways for opioid use disorder.

                Author information
                http://orcid.org/0000-0001-6397-7917
                http://orcid.org/0000-0001-9198-150X
                http://orcid.org/0000-0002-4884-6609
                http://orcid.org/0000-0003-0726-0676
                http://orcid.org/0000-0002-7724-691X
                http://orcid.org/0000-0002-5475-2713
                http://orcid.org/0000-0002-7612-8903
                Article
                Publisher ID: PMEDICINE-D-19-02372
                DOI: 10.1371/journal.pmed.1002969
                PMC ID: 6957118
                PubMed ID: 31770387
                SO-VID: 0f2ce6ab-1963-4aab-9b55-cda7e0474792
                Copyright © © 2019 Tsai et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Page count
                Figures: 0, Tables: 0, Pages: 18
                Funding
                The authors received no specific funding for this work.
                Categories
                Subject: Policy Forum
                Subject: Medicine and Health Sciences
                Subject: Pharmacology
                Subject: Drugs
                Subject: Analgesics
                Subject: Opioids
                Subject: Medicine and Health Sciences
                Subject: Pain Management
                Subject: Analgesics
                Subject: Opioids
                Subject: Medicine and Health Sciences
                Subject: Pharmacology
                Subject: Drugs
                Subject: Opioids
                Subject: Medicine and Health Sciences
                Subject: Pharmaceutics
                Subject: Drug Therapy
                Subject: Social Sciences
                Subject: Political Science
                Subject: Public Policy
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Behavior
                Subject: Social Sciences
                Subject: Psychology
                Subject: Behavior
                Subject: Medicine and Health Sciences
                Subject: Public and Occupational Health
                Subject: Behavioral and Social Aspects of Health
                Subject: People and Places
                Subject: Population Groupings
                Subject: Professions
                Subject: Medical Personnel
                Subject: Medical Doctors
                Subject: Physicians
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Health Care Providers
                Subject: Medical Doctors
                Subject: Physicians
                Subject: Medicine and Health Sciences
                Subject: Public and Occupational Health
                Subject: Social Sciences
                Subject: Law and Legal Sciences
                Subject: Criminal Justice System
                Subject: Law Enforcement

                ScienceOpen disciplines: Medicine
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                ScienceOpen disciplines: Medicine

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