Less Stigma for More Health

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Minimizing harm by identifying and targeting negative beliefs about people who use opioids.
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A key feature of stigma is that it socially discredits those who are its targets, thereby diminishing a person’s power within society.
Opioids are causing significant harm to Canadians.
 
Opioids refer to a broad group of pain-relieving drugs. Some of these are illegal like heroin, whereas others are legal and can be prescribed to manage severe chronic pain. According to the Public Health Agency of Canada, opioids were implicated in 4,614 deaths and 5,349 hospitalizations across Canada in 2018. 
 
Dr. Daniel Buchman led a study to improve our understanding of the different types of stigma that affect opioid users. 
 
Stigma refers to negative public attitudes and beliefs about a group of people who share a specific demographic quality. Further, these beliefs and attitudes can cause individuals in the group to be marginalized and labeled as ‘deviant’ by others. People who use opioids and people living with opioid use disorder are often the target of stigma, and labels such as ‘addict’ and ‘junkie’ are examples of stigmatizing language that could lead to discrimination. 
 
“It is well established that stigma worsens the health of targeted individuals by deterring them from seeking and/or accepting help for their condition,” says Dr. Buchman, a Clinician Investigator at Krembil Research Institute and a Bioethicist at Toronto Western Hospital. “Stigma can also be a major source of chronic stress in people’s lives.” 
 
As part of the study, he and his colleagues analyzed 51 academic papers about opioid-related stigma. They reported the existence of numerous types of stigma, which the team grouped into four distinct categories. These included stigmas towards people who are taking methadone and other medications for opioid use disorder; stigmas related to the use of opioids for chronic pain; stigmas related to attitudes among health care professionals; and self-stigmas in which feelings of self-blame, shame and despair prevent a person from seeking help for their opioid use.
 
“People who consume opioids are often marginalized by society,” explains Dr. Buchman. “Identifying the different types of stigma that these individuals face will help policymakers develop targeted strategies that will minimize the harm caused by opioid consumption.”
 
This work was supported by the University Health Network.
 
McCradden MD, Vasileva D, Orchanian-Cheff A, Buchman DZ. Ambiguous identities of drugs and people: A scoping review of opioid-related stigma. Int J Drug Policy. 2019 Dec. doi: 10.1016/j.drugpo.2019.10.005. 

Dr. Daniel Buchman, Clinician Investigator, Krembil Research Institute.