Stigma and Social Support in Pharmaceutical Opioid Treatment Populations: a Scoping Review

Cooper, Samantha; Nielsen, Suzanne

doi:10.1007/s11469-016-9719-6

Cited by 58 publications

(32 citation statements)

References 60 publications

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“…Clients internalized this pressure and stigma, and often stopped medication in an attempt to recover without it, which can subsequently increase risk of relapse or overdose. This barrier has been observed in other studies, and often serves as a persistent deterrent to long-term OAT maintenance (Monico et al, 2015; Cooper & Nielsen, 2017). In an effort to combat this, it has been suggested that there is a need for recovery groups that recognize individuals on medication as being in recovery and destigmatize medication use to treat OUD (Krawczyk et al, 2018).…”

Section: Discussionsupporting

confidence: 62%

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Truong

Krawczyk

Dejman

et al. 2019

Addictive Behaviors

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Objective: This qualitative study identifies and describes experiences and challenges to retention of individuals with opioid use disorder (OUD) who participated in a low-threshold combined buprenorphine-peer support treatment program in Baltimore. Methods: In-depth semi-structured interviews with staff and former clients of the Project Connections Buprenorphine Program (PCBP) (9 people) and focus group discussions with current and previous clients of PCBP (7 people) were conducted. Content analysis was used to extract themes regarding barriers to enrolling and remaining in, and transitioning from the program. Results: Primary challenges identified by the participants included struggles with cravings and symptoms of withdrawal, comorbid mental health issues, criminal justice system involvement, medication stigma, and conflicts over level of flexibility regarding program requirements and the role of employment. Conclusions: This study identified several obstacles clients face when seeking care through a combined bupre- norphine-peer support model. Findings highlight potential programmatic factors that can be improved and additional resources that may support treatment retention rates and better outcomes. Despite challenges, low- threshold and community-based programs can increase access to effective maintenance treatment for OUD, especially among vulnerable populations who may not have access to formal health services.

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Section: Discussionsupporting

confidence: 62%

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Truong

Krawczyk

Dejman

et al. 2019

Addictive Behaviors

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“…While research on MMT stigma is limited, prior work has predominantly studied it as a continuation of substance use stigma among people in treatment versus stigma uniquely related to methadone . Our findings indicate that PLWOUD receiving MMT are probably contending with substance use and MMT stigma as two distinct but intersecting forces versus merely a continuation of one stigmatized identity.…”

Section: Discussionmentioning

confidence: 72%

Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT‐SMS)

et al. 2019

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Background and aim Experience of stigma towards methadone maintenance treatment (MMT) may be a barrier to the use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct and criterion validity of a theory-based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS) and compared this with the Substance Use Stigma Mechanism Scale (SU-SMS). Design Surveys at the beginning and end of a prospective study together with records of drug use and treatment attendance during that study. Setting Community methadone clinic in the Northeastern USA. Participants Ninety-three participants who were receiving MMT; the average daily methadone dose was 84.8 mg/day (standard deviation = 28.39 mg/day).Measurements The MMT-SMS uses a self-report questionnaire to assess three dimensions reflecting experiences of anticipated (nine items), enacted (nine items) and internalized stigma (seven items) specifically related to receiving MMT. Anticipated and enacted scales include three stigma source subscales (family, employers, health care workers; three items each). Responses are recorded on a five-point Likert-type scale, then averaged to produce the MMT-SMS scale/subscale scores. The SU-SMS is a self-report questionnaire to assess experiences of anticipated, enacted and internalized stigma regarding substance use history. Both scales were administered at the final parent study visit. Other measures included were assessed in the parent study and used to assess life-time and recent MMT (e.g. current MMT dose) and drug use experiences (e.g. past 30-day heroin injection). Findings The MMT-SMS demonstrated good internal reliability (α = 0.806-0.952 for components). Confirmatory factor analysis supported the seven-factor scale structure, distinguishing between experiences of anticipated, enacted and internalized stigma, and anticipated and enacted stigma source subscales (family, employers, health care workers) [root mean square error of approximation (RMSEA) = 0.076, 90% confidence interval (CI) = 0.061-0.090, P-close = 0.003; confirmatory fit index (CFI) = 0.974; Tucker-Lewis index (TLI) = 0.971]. Construct validity helped to distinguish the MMT-SMS from established substance use stigma constructs. Criterion validity observed associations with substance use experiences while on MMT, likely to predict future MMT success. Internalized MMT stigma was uniquely associated with daily MMT dose. Regarding criterion validity: anticipated MMT and enacted substance use stigma were associated with past 30-day heroin injection, MMT stigma uniquely associated with opioid use behaviors while receiving MMT, and substance use stigma broadly associated with injection-related behaviors. Conclusions The Methadone Maintenance Treatment Stigma Mechanisms Scale appears to be a reliable measure of methadone maintenance treatment stigma with robust validity in a sample of people with opioid use disorders receiving methadone maintenance treatment.

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“…Positive moods and emotions strongly predict positive health behavior change (Craddock et al, 2015). This is likely due to increased perceived value of the events and actions that elicited the positive feedback from close others .…”

Section: Emotion Regulationmentioning

confidence: 96%

“…For instance, management of chronic diseases including depression and other forms of mental illness is facilitated by social support processes, particularly as the means to soliciting and receiving assistance pursuing the goal of mental health expand beyond in‐person interactions and into social media exchanges (e.g., Naslund, Aschbrenner, Marsch, & Bartels, ). Likewise, coping and recovering from opioid addiction is impaired when social support is minimal (Cooper & Nielsen, ). Given the additive benefits of regular physical activity and healthy eating in tandem with additional health preventive behaviors such as maintaining an optimal weight, not smoking, and drinking alcohol in moderation (Loef & Walach, ), adopting a more holistic health‐based inter personal focus for support interventions could prove particularly effective.…”

Section: Future Directionsmentioning

confidence: 99%

“…Such social monitoring can also lead to the formation of interdependent feedback loops in which close individuals regulate the maintenance of health behaviors via reminders and feelings of both mutual responsibility and accountability (see Craddock, van Dellen, Novak, & Ranby, 2015). Romantic partners and parents, for instance, tend to monitor one another's choices and behaviors in ways that improve health outcomes, including increased physical activity and healthier carbohydrate consumption (e.g., Lewis & Butterfield, 2007;Umberson, 1987).…”

Section: Self-monitoring and Social Monitoringmentioning

confidence: 99%

See 1 more Smart Citation

Interpersonal pursuit of intrapersonal health goals: Social cognitive–motivational mechanisms by which social support promotes self‐regulatory success

Riccio

Shrout

Balcetis

2019

Social & Personality Psych

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The short‐ and long‐term health benefits of both regular physical activity and healthy eating are well established for persons of all ages. Despite publicity about these benefits and publications of activity and healthy‐eating guidelines, many people struggle with implementing exercise and eating goals. With this work, we propose multiple social cognitive–motivational mechanisms by which social support can promote self‐regulatory success in these domains. Specifically, we outline how interpersonal processes can improve both action planning and action control across the pre‐action, action, and post‐action phases of physical activity and healthy‐eating goal pursuit. We suggest that close relationships offer a promising avenue for improving and promoting individual‐level health behavior. We also discuss limitations, costs, and potential future interventions relating to health, social support, and interpersonal processes.

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Stigma and Social Support in Pharmaceutical Opioid Treatment Populations: a Scoping Review

Cited by 58 publications

References 60 publications

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT‐SMS)

Interpersonal pursuit of intrapersonal health goals: Social cognitive–motivational mechanisms by which social support promotes self‐regulatory success

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