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      Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders

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          Abstract

          Substance-use disorders are a public health crisis globally and carry with them significant morbidity and mortality. Stigma toward people who abuse these substances, as well as the internalization of that stigma by substance users, is widespread. In this review, we synthesized the available evidence for the role of perceived social stigma and self-stigma in people’s willingness to seek treatment. While stigma may be frequently cited as a barrier to treatment in some samples, the degree of its impact on decision-making regarding treatment varied widely. More research needs to be done to standardize the definition and measurement of self- and perceived social stigma to fully determine the magnitude of their effect on treatment-seeking decisions.

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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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            Alcohol treatment utilization: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.

            Emily Cohen Cavell, Henry R Kranzler, Richard Feinn … (2007)
            Epidemiological studies consistently show low rates of alcohol treatment utilization among individuals with an alcohol use disorder (AUD). However, there is not as great consistency in the characteristics that predict alcohol treatment utilization. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined attributes associated with treatment utilization among individuals with an AUD. We used stepwise backward selection logistic regression analysis to examine demographic and clinical predictors of treatment utilization, in order to identify opportunities to improve the delivery of services to this population. Only 14.6% of individuals who met lifetime criteria for an AUD reported ever having received alcohol treatment (including self-help group participation). A greater proportion of respondents with both alcohol abuse and dependence (27.9%) reported having received treatment, compared with 7.5% of those with alcohol abuse only and 4.8% of those with alcohol dependence only. Older individuals, men, and those who were divorced, had less education or more lifetime comorbid mood, personality, and drug use disorders were also more likely to have received treatment. The majority of individuals with an AUD never receive formal alcohol treatment, nor do they participate in self-help groups. Although natural recovery from an AUD is well documented, participation in alcohol treatment is associated with improved outcomes. The data presented here should be taken into account when efforts are made to enhance alcohol treatment utilization.
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              The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings.

              Deborah Hasin, Bridget F Grant (2015)
              The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking.
              Article 0 comments Cited 104 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Subst Abuse Rehabil
                Journal ID (iso-abbrev): Subst Abuse Rehabil
                Journal ID (publisher-id): Substance Abuse and Rehabilitation
                Title: Substance Abuse and Rehabilitation
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-8467
                Publication date Collection: 2018
                Publication date (Electronic): 23 November 2018
                Volume: 9
                Pages: 115-136
                Affiliations
                [1 ]Our Lady of the Lake Division of Academic Affairs, Baton Rouge, LA, USA
                [2 ]Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA, Kcrap1@ 123456lsuhsc.edu
                Author notes
                Correspondence: KA Crapanzano, Department of Psychiatry, Louisiana State University Health Sciences Center, 5246 Brittany Drive – 3rd floor, Baton Rouge, LA 70808, USA, Tel +1 225 757 4212, Fax +1 225 757 4210, Email Kcrap1@ 123456lsuhsc.edu
                Article
                Publisher ID: sar-9-115
                DOI: 10.2147/SAR.S183256
                PMC ID: 6260179
                PubMed ID: 30538599
                SO-VID: edd48011-5a9d-4c01-9d51-2cb0f5e1a9b6
                Copyright © © 2018 Hammarlund et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Subject: Review

                Keywords: self-stigma,perceived social stigma,substance-use disorders,treatment seeking
                Data availability:
                Keywords: self-stigma, perceived social stigma, substance-use disorders, treatment seeking

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