Professional education to reduce provider stigma toward harm reduction and pharmacotherapy

Abstract

Aims: A novel professional training was developed to reduce stigma toward harm reduction and pharmacotherapy for substance use disorders. Methods: The training was delivered over three sessions to n ¼ 147 health professionals in Utah between 2019 and 2020, including n ¼ 40 substance use disorder treatment professionals. Pre and post-training survey measures provided evaluation information on knowledge, attitudes, and planned action regarding harm reduction and pharmacotherapy. Items were grouped into a stigma score, and multilevel modeling, regression analyses, and McNemar tests were used to quantify changes in overall stigma toward harm reduction interventions both before and after the training. Results: The training significantly decreased the total stigma score toward harm reduction (b ¼ À0.09, p < .001, b ¼ À0.34).At the individual item level, 6 of the 22 items showed significant change in reduced stigma (all p < .047), and all items moved in the direction of decreased stigma. These items include both attitudes and planned action aspects of the total stigma score. Conclusions: This study suggests that education targeting prejudice and discriminatory actions against harm reduction and pharmacotherapy interventions among healthcare professionals may contribute to stigma reduction. These results provide a basis for intervention effectiveness, addressing preconceived ideas, and show community need for such substance use interventions, as a component of future stigma reduction efforts.

Experiences of healthcare and substance use treatment provider-based stigma among patients receiving methadone

“…A small but growing body of research demonstrates the impact of MOUD training on provider attitudes ( Kennedy-Hendricks et al., 2020 ; Sulzer et al., 2021 ). MOUD training opportunities should be expanded, tailored, or improved, particularly for healthcare providers who engage people with OUD outside substance use treatment settings.…”

“There’s absolutely no downside to this, I mean, except community opposition:” A qualitative study of the acceptability of vending machines for harm reduction

“…This evidence supports the reverse, that harm reduction interventions have been linked to positive health outcomes for PWID both in the short term, and in the long term by preventing infectious diseases and connecting people to treatment [ 11 , 22 , 31 ], This evidence is necessary but not sufficient to combat misinformation about harm reduction. Future research should test and compare messaging packages that effectively combat the idea that “you are just helping them get high.” There have been promising professional education efforts to reduce provider stigma toward harm reduction, and related efforts are needed toward educating the general public that harm reduction is effective, a better option for many opioid users who are not currently interested in treatment, and better for the community in both the short and long term [ 37 ]. Before any VMHR implementation, any ambassadors of VMHR should be provided with coaching, evidence-based toolkits, and talking points about harm reduction and in response to its most common critiques to encourage community buy-in.…”

“There’s absolutely no downside to this, I mean except community opposition:” A qualitative study of the acceptability of vending machines for harm reduction

“…Future research should test and compare messaging packages that effectively combat the idea that "you are just helping them get high." There have been recent promising professional education efforts to reduce provider stigma towards harm reduction, and related efforts are needed towards educating the general public that harm reduction is effective, better for many opioid users, and better for the community in both the short and long-term (Sulzer et al, 2022). Before any VMHR implementation, any ambassadors of VMHR should be provided with coaching, evidence-based toolkits, and talking points about harm reduction and in response to its most common critiques to encourage community buy-in.…”