Are the self-stigma and perceived stigma of patients treated with methadone or buprenorphine still a problem fifty years after the marketing authorization for opioid agonist treatment? The observational STIGMA study.
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引用次数: 0
Abstract
Background: In the context of the opioid overdose crisis, understanding the barriers to seeking, attaining and remaining in treatment for patients with opioid use disorder (OUD) is a public health issue. To date, very few studies have assessed the "self-stigma" (i.e., the internalization of negative societal attitudes and stereotypes about oneself, leading to self-judgment) and "perceived stigma" (i.e., the belief that others hold negative attitudes towards oneself due to a particular condition) experienced by patients with OUD receiving opioid agonist treatment (OAT), and none have done so in France. Our study aimed to quantify self-stigma, explore some aspects of perceived stigma, determine the factors associated with greater self-stigma and examine whether the level of self-stigma was related to a delay in seeking care.
Methods: The STIGMA study was a monocentric, cross-sectional study. The data were collected in a French hospital addiction medicine department. Participants were outpatients with current or past OUD who were still receiving or had received OAT. A questionnaire assessing sociodemographics; OUD characteristics; perceived stigma; and quantification of self-stigma by the Self-Stigma Scale-Short, was administered.
Results: A total of 73 questionnaires were included in the analysis. Nearly two-thirds of the patients had a "moderate to high" level of self-stigma. These patients were significantly younger at OUD onset and were significantly more likely to have at least one dependent child than patients reporting a "very low to low" level of self-stigma. Nearly half of the participants experienced perceived stigma from a healthcare professional regarding their OUD or OAT, and nearly one-third of the participants were refused care from a healthcare professional because of their OUD or OAT. Moreover, a quarter of the sample reported delaying care due to fear of being stigmatized. We did not find a relationship between self-stigma levels and a delay in seeking care.
Conclusions: Our study highlights the need to detect stigma and to improve training in addiction medicine.
期刊介绍：
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use.
Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations.
Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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