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The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review

James D. Livingston, Teresa Milne, Mei Lan Fang and 1 more

Addiction · 2011 · Systematic review

doi:10.1111/j.1360-0443.2011.03601.x

Abstract

Aims This study provides a systematic review of existing research that has empirically evaluated interventions designed to reduce stigma related to substance use disorders. Methods A comprehensive review of electronic databases was conducted to identify evaluations of substance use disorder related stigma interventions. Studies that met inclusion criteria were synthesized and assessed using systematic review methods. Results Thirteen studies met the inclusion criteria. The methodological quality of the studies was moderately strong. Interventions of three studies (23%) focused on people with substance use disorders (self‐stigma), three studies (23%) targeted the general public (social stigma) and seven studies (54%) focused on medical students and other professional groups (structural stigma). Nine interventions (69%) used approaches that included education and/or direct contact with people who have substance use disorders. All but one study indicated their interventions produced positive effects on at least one stigma outcome measure. None of the interventions have been evaluated across different settings or populations. Conclusions A range of interventions demonstrate promise for achieving meaningful improvements in stigma related to substance use disorders. The limited evidence indicates that self‐stigma can be reduced through therapeutic interventions such as group‐based acceptance and commitment therapy. Effective strategies for addressing social stigma include motivational interviewing and communicating positive stories of people with substance use disorders. For changing stigma at a structural level, contact‐based training and education programs targeting medical students and professionals (e.g. police, counsellors) are effective.

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References 75

  1. 1.

    Manzo JF. On the sociology and social organization of stigma: some ethnomethodological insights. Hum Stud. 2004;27:401-16.

    Not in our library

  2. 2.

    Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71:2150-61.

    Not in our library10.1016/j.socscimed.2010.09.030

  3. 3.

    Logie C, Gadalla TM. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21:742-53.

    Not in our library10.1080/09540120802511877

  4. 4.

    Mak WW, Poon CY, Pun LY, Cheung SF. Meta-analysis of stigma and mental health. Soc Sci Med. 2007;65:245-61.

    Not in our library10.1016/j.socscimed.2007.03.015

  5. 5.

    Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2011.

    Not in our library10.1177/0193945911400638

  6. 6.

    Schachter HM, Girardi A, Ly M, Lacroix D, Lumb AB, van Berkom J, et al. Effects of school-based interventions on mental health stigmatization: a systematic review. Child Adolesc Psychiatry Ment Health. 2008;2.

    Not in our library10.1186/1753-2000-2-18

  7. 7.

    Weiss MG, Ramakrishna J, Somma D. Health-related stigma: rethinking concepts and interventions. Psychol Health Med. 2006;11:277-87.

    Not in our library10.1080/13548500600595053

  8. 8.

    Corrigan P, Kerr A, Knudsen L. The stigma of mental illness: explanatory models and methods for change. Appl Prev Psychol. 2005;11:179-90.

    Not in our library

  9. 9.

    Herek GM. Confronting sexual stigma and prejudice: theory and practice. J Soc Issues. 2007;63:905-25.

    Not in our library

  10. 10.

    Herek GM, Gillis JR, Cogan JC. Internalized stigma among sexual minority adults: insights from a social psychological perspective. J Couns Psychol. 2009;56:32-43.

    Not in our library

  11. 11.

    Corrigan PW, Roe D, Tsang HW. Challenging the Stigma of Mental Illness: Lessons for Therapists and Advocates. 2011.

    Not in our library

  12. 12.

    Heflinger CA, Hinshaw SP. Stigma in child and adolescent mental health services research: understanding professional and institutional stigmatization of youth with mental health problems and their families. Adm Policy Ment Health. 2010;37:61-70.

    Not in our library10.1007/s10488-010-0294-z

  13. 13.

    Lee S, Chiu MYL, Tsang A, Chui H, Kleinman A. Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Soc Sci Med. 2006;62:1685-96.

    Not in our library10.1016/j.socscimed.2005.08.016

  14. 14.

    Corrigan P, Markowitz F, Watson A. Structural levels of mental illness stigma and discrimination. Schizophr Bull. 2004;30:481-91.

    Not in our library10.1093/oxfordjournals.schbul.a007096

  15. 15.

    Heijnders M, Van Der Meij S. The fight against stigma: an overview of stigma-reduction strategies and interventions. Psychol Health Med. 2006;11:353-63.

    Not in our library10.1080/13548500600595327

  16. 16.

    Rao H, Mahadevappa H, Pillay P, Sessay M, Abraham A, Luty J. A study of stigmatized attitudes towards people with mental health problems among health professionals. J Psychiatr Ment Health Nurs. 2009;16:279-84.

    Not in our library10.1111/j.1365-2850.2008.01369.x

  17. 17.

    Ronzani TM, Higgins-Biddle J, Furtado EF. Stigmatization of alcohol and other drug users by primary care providers in Southeast Brazil. Soc Sci Med. 2009;69:1080-4.

    Not in our library10.1016/j.socscimed.2009.07.026

  18. 18.

    Room R. Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev. 2005;24:143-55.

    Not in our library10.1080/09595230500102434

  19. 19.

    Corrigan PW, Lurie BD, Goldman HH, Slopen N, Medasani K, Phelan S. How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatr Serv. 2005;56:544-50.

    Not in our library10.1176/appi.ps.56.5.544

  20. 20.

    Schomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC. The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol. 2011;46:105-12.

    Not in our library10.1093/alcalc/agq089

  21. 21.

    Bayer R. Stigma and the ethics of public health: not can we but should we. Soc Sci Med. 2008;67:463-72.

    Not in our library10.1016/j.socscimed.2008.03.017

  22. 22.

    Buchanan J, Young L. The war on drugs—a war on drug users. Drugs Educ Prev Policy. 2000;7:409-22.

    Not in our library

  23. 23.

    Stuber J, Meyer I, Link B. Stigma, prejudice, discrimination and health. Soc Sci Med. 2008;67:351-7.

    Not in our library10.1016/j.socscimed.2008.03.023

  24. 24.

    Adlaf EM, Hamilton HA, Wu F, Noh S. Adolescent stigma towards drug addiction: effects of age and drug use behaviour. Addict Behav. 2009;34:360-4.

    Not in our library10.1016/j.addbeh.2008.11.012

  25. 25.

    Satel S, Henningfield JE, Santora PB, Bickel WK. In praise of stigma. Addiction Treatment: Science and Police for the Twenty-First Century. 2007;147-51.

    Not in our library

  26. 26.

    Dean JC, Poremba GA. The alcoholic stigma and the disease concept. Int J Addict. 1983;18:739-51.

    Not in our library10.3109/10826088309027366

  27. 27.

    Dean JC, Rud F. The drug addict and the stigma of addiction. Int J Addict. 1984;19:859-69.

    Not in our library10.3109/10826088409061991

  28. 28.

    Habib SE, Adorjany LV. Hepatitis C and injecting drug use: the realities of stigmatization and discrimination. Health Educ J. 2003;62:256-65.

    Not in our library

  29. 29.

    Rasinski KA, Woll P, Cooke A, Corrigan PW. Stigma and substance use disorders. On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. 2005;219-36.

    Not in our library

  30. 30.

    Corrigan PW, Watson AC, Byrne P, Davis KE. Mental illness stigma: problem of public health or social justice? Soc Work. 2005;50:363-8.

    Not in our library10.1093/sw/50.4.363

  31. 31.

    Radcliffe P, Stevens A. Are drug treatment services only for ‘thieving junkie scumbags’? Drug users and the management of stigmatised identities. Soc Sci Med. 2008;67:1065-73.

    Not in our library10.1016/j.socscimed.2008.06.004

  32. 32.

    Cunningham JA, Sobell LC, Freedman JL, Sobell MB. Beliefs about the causes of substance abuse: a comparison of three drugs. J Subst Abuse. 1994;6:219-26.

    Not in our library10.1016/s0899-3289(94)90241-0

  33. 33.

    Ahern J, Stuber J, Galea S. Stigma, discrimination and the health of illicit drug users. Drug Alcohol Depend. 2007;88:188-96.

    Not in our library10.1016/j.drugalcdep.2006.10.014

  34. 34.

    Erikson KT. Notes on the sociology of deviance. Soc Probl. 1962;9:307-14.

    Not in our library

  35. 35.

    Albrecht GL, Walker VG, Levy JA. Social distance from the stigmatized. a test of two theories. Soc Sci Med. 1982;16:1319-27.

    Not in our library10.1016/0277-9536(82)90027-2

  36. 36.

    Corrigan PW, Kuwabara SA, O'Shaughnessy J. The public stigma of mental illness and drug addiction: findings from a stratified random sample. J Soc Work. 2009;9:139-47.

    Not in our library

  37. 37.

    Corrigan P. Mental health stigma as social attribution: implications for research methods and attitude change. Clin Psychol Sci Pract. 2000;7:48-67.

    Not in our library

  38. 38.

    Corrigan P, Markowitz F, Watson A, Rowan D, Kubiak M. An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav. 2003;44:162-79.

    Not in our library

  39. 39.

    Link B, Struening EL, Rahav M, Phelan JC, Nuttbrock L. On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. J Health Soc Behav. 1997;38:177-90.

    Not in our library

  40. 40.

    Brener L, von Hippel W, von Hippel C, Resnick I, Treloar C. Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: utility of a mixed methods approach. Drug Alcohol Rev. 2010;29:491-7.

    Not in our library10.1111/j.1465-3362.2010.00173.x

  41. 41.

    Brewer MK. The contextual factors that foster and hinder the process of recovery for alcohol dependent women. J Addict Nurs. 2006;17:175-80.

    Not in our library

  42. 42.
  43. 43.

    Simmonds L, Coomber R. Injecting drug users: a stigmatised and stigmatising population. Int J Drug Policy. 2009;20:121-30.

    Not in our library10.1016/j.drugpo.2007.09.002

  44. 44.

    Copeland J. A qualitative study of barriers to formal treatment among women who self-managed change in addictive behaviours. J Subst Abuse Treat. 1997;14:183-90.

    Not in our library10.1016/s0740-5472(96)00108-0

  45. 45.

    Digiusto E, Treloar C. Equity of access to treatment, and barriers to treatment for illicit drug use in Australia. Addiction. 2007;102:958-69.

    Not in our library10.1111/j.1360-0443.2007.01842.x

  46. 46.

    Keyes K, Hatzenbuehler M, McLaughlin K, Link B, Olfson M, Grant B, et al. Stigma and treatment of alcohol disorders in the United States. Compr Psychiatry. 2010;51:e6.

    Not in our library10.1093/aje/kwq304

  47. 47.

    Semple SJ, Grant I, Patterson TL. Utilization of drug treatment programs by methamphetamine users: the role of social stigma. Am J Addict. 2005;14:367-80.

    Not in our library10.1080/10550490591006924

  48. 48.

    Henderson S, Stacey CL, Dohan D. Social stigma and the dilemmas of providing care to substance users in a safety-net emergency department. J Health Care Poor Underserved. 2008;19:1336-49.

    Not in our library10.1353/hpu.0.0088

  49. 49.

    Anstice S, Strike CJ, Brands B. Supervised methadone consumption: client issues and stigma. Subst Use Misuse. 2009;44:794-808.

    Not in our library10.1080/10826080802483936

  50. 50.

    McGonagle D. Methadone anonymous: a 12-step program. reducing the stigma of methadone use. J Psychosoc Nurs Ment Health Serv. 1994;32:5-12.

    Not in our library10.3928/0279-3695-19941001-04

  51. 51.

    Vigilant LG. The stigma paradox in methadone maintenance: naive and positive consequences of a ‘treatment punishment’ approach to opiate addiction. Humanity Soc. 2004;28:403-18.

    Not in our library

  52. 52.

    Shah S, Diwan S. Methadone: does stigma play a role as a barrier to treatment of chronic pain? Pain Physician. 2010;13:289-93.

    Not in our library

  53. 53.

    A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy. 2008.

    Not in our library

  54. 54.

    Toward Recovery & Well-Being: A Framework for a Mental Health Strategy for Canada. 2009.

    Not in our library

  55. 55.

    Health Minds, Healthy People: A Ten-Year Plan to address Mental Health and Substance Use in British Columbia. 2010.

    Not in our library

  56. 56.

    Zaza S, Wright-De Aguero LK, Briss PA, Truman BI, Hopkins DP, Hennessy MH, et al. Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services. Am J Prev Med. 2000;18:44-74.

    Not in our library10.1016/s0749-3797(99)00122-1

  57. 57.

    Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Commun Health. 1998;52:377-84.

    Not in our library10.1136/jech.52.6.377

  58. 58.

    Bahora M, Hanafi S, Chien VH, Compton MT. Preliminary evidence of effects of crisis intervention team training on self-efficacy and social distance. Adm Policy Ment Health. 2008;35:159-67.

    Not in our library10.1007/s10488-007-0153-8

  59. 59.

    Ballon BC, Skinner W. ‘Attitude is a little thing that makes a big difference’: reflection techniques for addiction psychiatry training. Acad Psychiatry. 2008;32:218-24.

    Not in our library10.1176/appi.ap.32.3.218

  60. 60.

    Bland E, Oppenheimer L, Brisson-Carroll G, Morel C, Holmes P, Gruslin A. Influence of an educational program on medical students' attitudes to substance use disorders in pregnancy. Am J Drug Alcohol Abuse. 2001;27:483-90.

    Not in our library10.1081/ada-100104513

  61. 61.

    Hayes SC, Bissett R, Roget N, Padilla M, Kohlenberg Fisher G, Masuda A, et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004;35:821-35.

    Not in our library

  62. 62.

    Luoma JB, Kohlenberg BS, Hayes SC, Bunting K, Rye AK. Reducing self-stigma in substance abuse through acceptance and commitment therapy: model, manual development, and pilot outcomes. Addict Res Theory. 2008;16:149-65.

    Not in our library10.1080/16066350701850295

  63. 63.

    Luty J, Rao H, Arokiadass SMR, Easow JM, Sarkhel A. The repentant sinner: methods to reduce stigmatised attitudes towards mental illness. Psychiatr Bull. 2008;32:327-32.

    Not in our library

  64. 64.

    Luty J, Umoh O, Nuamah F. Effect of brief motivational interviewing on stigmatised attitudes towards mental illness. Psychiatr Bull. 2009;33:212-4.

    Not in our library

  65. 65.

    Luty J, Umoh O, Sessay M, Sarkhel A. Effectiveness of Changing Minds campaign factsheets in reducing stigmatised attitudes towards mental illness. Psychiatr Bull. 2007;31:377-81.

    Not in our library

  66. 66.

    Meng C, Rayburn BB, Ramirez-Cacho WA, Rayburn WF. Effect of a specialized prenatal clinic on medical student attitudes toward women with drinking problems. J Matern Fetal Neonat Med. 2007;20:217-20.

    Not in our library10.1080/14767050601057564

  67. 67.

    Services Research Report. Skills Training and Employment for Ex-Addicts in Washington, DC: A Report on TREAT. 1978.

    Not in our library

  68. 68.

    Ramirez-Cacho WA, Strickland L, Beraun C, Meng C, Rayburn WF. Medical students' attitudes toward pregnant women with substance use disorders. Am J Obstet Gynecol. 2007;196:86.

    Not in our library10.1016/j.ajog.2006.06.092

  69. 69.

    Shuster MM, Lewin ML. Needle tracks in narcotic addicts. NY State J Med. 1968;68:3129-34.

    Not in our library

  70. 70.

    Silins E, Conigrave KM, Rakvin C, Dobbins T, Curry K. The influence of structured education and clinical experience on the attitudes of medical students towards substance misusers. Drug Alcohol Rev. 2007;26:191-200.

    Not in our library10.1080/09595230601184661

  71. 71.

    Link B, Struening E, Neese-Todd S, Asmussen S, Phelan JC. On describing and seeking to change the experience of stigma. Psychiatr Rehabil J. 2002;6:201-31.

    Not in our library

  72. 72.

    Corrigan P, Rafacz J, Hautamaki J, Walton J, Rüsch N, Rao D, et al. Changing stigmatizing perceptions and recollections about mental illness: the effects of NAMI's In Our Own Voice. Commun Ment Health J. 2010;46:517-22.

    Not in our library10.1007/s10597-009-9287-3

  73. 73.

    Thornicroft G, Brohan E, Kassam A, Lewis-Holmes E. Reducing stigma and discrimination: candidate interventions. Int J Ment Health Syst. 2008;2:3.

    Not in our library10.1186/1752-4458-2-3

  74. 74.

    Stier A, Hinshaw SP. Explicit and implicit stigma against individuals with mental illness. Aust Psychol. 2007;42:106-17.

    Not in our library

  75. 75.

    Rüsch N, Corrigan PW, Todd AR, Bodenhausen GV. Implicit self-stigma in people with mental illness. J Nerv Ment Dis. 2010;198:150-3.

    Not in our library10.1097/nmd.0b013e3181cc43b5

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