Cultural Models of Substance Use Risk and Attributed Stigma: A Comparison of Young Adults in Brazil and the United States

The stigma associated with substance use is well known, but little research has examined stigma attribution, or the tendency to stigmatize, nor is there much cross-cultural research on the topic. We examine cultural models for the risk of substance use associated with stigma attribution in two settings: the United States and Brazil. Study populations of young adults are the focus in each setting. Using methods of cultural domain analysis, cultural consensus analysis, and the analysis of residual agreement, we find similar models in each society. There is a continuum from viewing substance use risk as a biopsychosocial problem to viewing it as a moral issue. In the United States, viewing substance use as a biopsychosocial issue is associated with lower attributed stigma; in Brazil, viewing substance use as a biopsychosocial issue is associated with higher attributed stigma. We argue that social patterns of drug use in each society underlie this difference.