Identifying the trajectory of public stigma across the stages of recovery from a substance use disorder.

Abstract

Stigma felt by those with substance use disorders (SUDs) is both well documented and often a barrier to seeking treatment. This research was designed to better understand how stigma may change as people enter recovery and to document the trajectory of public stigma toward those in the three stages of recovery from a SUD (i.e., early, sustained, long-term). Participants (N = 185) were randomly assigned to read one of five brief vignettes about the life events a person who (1) had no history of a SUD, (2) was currently using heroin, or was in (3) early recovery-6 months, (4) sustained recovery-2 years, or (5) long-term recovery-5 years. Findings from this study revealed that public stigmatization is frequently lower for those in recovery from a SUD than for those currently using and that stigma is similar across all three stages of recovery. Several factors of public stigma (i.e., bad character traits, support of discrimination) were less-strongly endorsed across all recovery stages, while endorsement of other stigma factors (i.e., perceptions of worthlessness or criminality) was higher in early recovery than in long-term recovery. Alternately, endorsement of good character traits and hopeful emotional reactions was quite high in early recovery and beyond. Obtaining a better understanding of how public stigmatization changes when directed at individuals at different stages of SUD recovery can help focus efforts on decreasing the remaining stigma. Clinical Impact StatementThe public applies less stigma and has more positive reactions to people in recovery from a substance use disorder than to those currently using drugs. The stigma is often similarly low regardless of how long someone has been in recovery, but certain stigmatizing attributes are still attached to those in early recovery more than to those in long-term recovery. More public education about what it means to be in recovery could lead to the public gaining an overall better understanding of this population and, ultimately, toward reducing the remaining stigma attached to those in recovery from a substance use disorder.