Substance Use Related Stigma: What we Know and the Way Forward.
OBJECTIVE
To conduct a systematic review of the literature investigating the relationship between stigma experienced by individuals who use drugs.


METHODS
We conducted an online literature search and identified articles related to stigma among individuals who use drugs. Studies evaluating associations between stigma and socio-demographic variables and if applicable clinical and substance use variables are presented. In addition, recommendations for future research are provided.


RESULTS
We identified 26 articles describing 28 studies evaluating stigma. The majorities of studies were published in the last 11 years and conducted in the U.S. Samples were relatively diverse: 41.7% of all participants who provided data identified as racial/ethnic minorities. The vast majority of the relationships between stigma and socio-demographic characteristics were included in only one or very few studies, which limits conclusions. The relationship between stigma and psychological well-being is the only consistent finding reported in the literature. Specifically, results suggest that stigma has a detrimental effect on psychological well-being among individuals who use drugs.


CONCLUSIONS
While this literature is expanding at a rapid pace, this review indicates several areas for future research and needed improvements in research methodology in this area. Specifically, lack of comprehensive description of sample characteristics, lack of construct identification and proper definition, a dearth of longitudinal studies and limited research describing relationships between stigma and substance use behavior are a few areas identified for further research.
Department of Psychiatry and Behavioral Sciences, Center for Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, USA.
Magdalena
M
Kulesza
Department of Psychiatry and Behavioral Sciences, Center for Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, USA.
Mary E
ME
Larimer
Department of Global Health, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA.
Deepa
D
Rao
Literature review; Stigma; Substance use