Interventions to reduce self-stigma in people who use drugs: A systematic review

Sibley, Adams L.; Colston, David C.; Go, Vivian F.

doi:10.1016/j.josat.2023.209284

Cited by 6 publications

(4 citation statements)

References 89 publications

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“…Almost all United States federal funding allocated to date addresses public stigma through mass media campaigns and education programs, though there are questions about the extent to which these approaches move the needle [24,[101][102][103][104]. Findings from this proposed study will add to the evidence base for self-stigma reduction as a necessary complement to public-facing initiatives in the stigma reduction toolkit [24,32]. Preliminary evidence from our formative qualitative study suggests that RESTART may be an acceptable approach to providing information and advice on self-stigma to PWUD.…”

Section: Discussionmentioning

confidence: 99%

“…RESTART provides a test case for extending the potential of SMS interventions to PWUD, a historically hard-to-reach and hardly reached population [95]. Despite widespread acknowledgement that stigma is a key barrier to harm reduction and treatment utilization, few studies have intervened on this construct among PWUD in active use [32]. Results of our study will address the current research gap of stigma reduction interventions for PWUD.…”

Section: Principal Findingsmentioning

confidence: 95%

“…In a recent systematic review of substance use self-stigma interventions, acceptance and commitment therapy (ACT), cognitive-behavioral therapy (CBT), and psychoeducation were the most common and efficacious approaches to address self-stigma in clinical encounters [32]. We reviewed ACT, CBT, and psychoeducational manuals to identify modalities that could be translated into brief messages.…”

Section: Message Effectsmentioning

confidence: 99%

“…A recent systematic review identified 15 intervention trials between 2011-2023 with promising evidence of effectiveness in reducing substance use self-stigma [32]. However, almost all studies were in clinical treatment facilities and in group settings, ironically failing to reach PWUD who may avoid these settings for fear of stigma [32]. Noting these gaps, we developed a novel self-help stigma reduction intervention for PWUD in active use premised on the theory of stigma resistance [33].…”

Section: Introductionmentioning

confidence: 99%

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An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study

Sibley,

Noar,

Muessig

et al. 2024

JMIR Res Protoc

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Background Stigma is a barrier to treatment and harm reduction seeking in people who use drugs. Most stigma reduction interventions offer psychotherapy or psychoeducation in group-based clinical settings, failing to reach people who are not in treatment. SMS text messaging is an effective and acceptable modality for delivering health information to people who use drugs and may be a suitable conduit for providing information and advice to understand and cope with stigma. Objective This paper presents the protocol for a study that aims to determine the feasibility, acceptability, and preliminary effectiveness of a 4-week automated SMS text message intervention to increase stigma resistance and reduce self-stigma in people who use drugs. Methods We designed a novel automated SMS text message intervention to address the four personal-level constructs of stigma resistance: (1) not believing stigma and catching and challenging stigmatizing thoughts, (2) empowering oneself through learning about substance use and one’s recovery, (3) maintaining one’s recovery and proving stigma wrong, and (4) developing a meaningful identity and purpose apart from one’s substance use. Theory-based messages were developed and pilot-tested in qualitative elicitation interviews with 22 people who use drugs, resulting in a library of 56 messages. In a single-group, within-subjects, community-based pilot trial, we will enroll 30 participants in the Resisting Stigma and Revaluating Your Thoughts (RESTART) intervention. Participants will receive 2 daily SMS text messages for 4 weeks. Implementation feasibility will be assessed through recruitment, enrollment, retention, and message delivery statistics. User feasibility and acceptability will be assessed at follow-up using 23 survey items informed by the Theoretical Framework of Acceptability. Primary effectiveness outcomes are changes in self-stigma (Substance Abuse Self-Stigma Scale) and stigma resistance (Stigma Resistance Scale) from baseline to follow-up measured via a self-administered survey. Secondary outcomes are changes in hope (Adult Dispositional Hope Scale) and self-esteem (Rosenberg Self-Esteem Scale). Feasibility and acceptability will be assessed with descriptive statistics; effectiveness outcomes will be assessed with paired 2-tailed t tests, and group differences will be explored using ANOVA. Overall, 12 participants will also be selected to complete acceptability interviews. Results This pilot study was funded by the National Institute on Drug Abuse in April 2023 and received regulatory approval in January 2024 by the University of North Carolina-Chapel Hill Institutional Review Board. Recruitment and enrollment began in March 2024. Follow-up visits are expected to conclude by May 2024. Results will be disseminated in relevant peer-reviewed journals. Conclusions To the best of our knowledge, this is the first study to address substance use stigma via a self-help SMS text messaging program. Results will add to the nascent literature on stigma reduction in people who use drugs. This protocol may interest researchers who are considering text messaging to address psychosocial needs in hard-to-reach populations. Trial Registration ClinicalTrials.gov NCT06281548; https://clinicaltrials.gov/ct2/show/NCT06281548 International Registered Report Identifier (IRRID) DERR1-10.2196/59224

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Section: Discussionmentioning

confidence: 99%

Section: Principal Findingsmentioning

confidence: 95%

Section: Message Effectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study

Sibley,

Noar,

Muessig

et al. 2024

JMIR Res Protoc

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Assoziation von Selbststigmatisierung und Abstinenz-Selbstwirksamkeitserwartung bei Patientinnen und Patienten mit Drogengebrauchsstörung

Herter,

Rumpf,

Bischof

et al. 2024

Suchttherapie

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Zusammenfassung Hintergrund Während ein negativer Zusammenhang von Selbststigmatisierung auf die Abstinenzbezogene Selbstwirksamkeitserwartung bei Patientinnen und Patienten mit einer Alkoholgebrauchsstörung Gut belegt ist, fehlen entsprechen-de Befunde bei Abhängigkeit von illegalen Substanzen. In der vorliegenden Arbeit wurde untersucht, wie Selbststigmatisierung bei Patientinnen und Patienten mit einer Substanzgebrauchsstörung, die illegale Substanzen konsumieren, asso-ziiert ist. Methode Es wurden Selbst- und Fremdstigmatisierung mit einer auf Drogen adaptierten Version der Self-Stigma in Alcohol Dependence Scale (SSAD) und die drogenbezogene Abstinenz-Selbstwirksamkeitserwartung (DASE) erfasst. Zur Auswertung der Zusammenhänge wurden Regressionsanalysen durchgeführt. Ergebnisse Insgesamt nahmen 70 Patientinnen und Patienten (86% männlich) an der Studie teil. Die Patientinnen und Patienten befanden sich zum Zeitpunkt der Befragung in Rehabilitationseinrichtungen mit dem Schwerpunkt illegale Substanzen. Eine Regressionsanalyse mit der Abstinenz-Selbstwirksamkeitserwartung als abhängige Variable ergab einen negativen sig-nifikanten Zusammenhang mit der Dauer der Abhängigkeit, der Depressivität und der Selbststigmatisierung. Die Selbststigmatisierung erwies sich als der stärkste negative Prädiktor für die Abstinenz-Selbstwirksamkeitserwartung. Schlussfolgerung Selbststigmatisierung steht in Zusammenhang mit der Abstinenz-Selbstwirksamkeitserwartung und sollte bei der Behandlung berücksichtigt werden. Weitere Forschung zu den Auswirkungen von Stigmatisierung und zu Interventionsansätzen zur Reduktion von (Selbst-)Stigmatisierung wird empfohlen.

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Understanding the complex health needs of people with problematic drug/alcohol use: a qualitative enquiry

Swainston,

Robinson,

Pinder

et al. 2024

Journal of Substance Use

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Interventions to reduce self-stigma in people who use drugs: A systematic review

Cited by 6 publications

References 89 publications

An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study

An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study

Assoziation von Selbststigmatisierung und Abstinenz-Selbstwirksamkeitserwartung bei Patientinnen und Patienten mit Drogengebrauchsstörung

Understanding the complex health needs of people with problematic drug/alcohol use: a qualitative enquiry

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