The Internet as a Tool for Liver Transplant Programs to Combat Stigma Related to Alcohol Use Disorder

Choosing appropriate language to reduce the stigma around mental illness and substance use disorders

“…Likewise, refer to someone as being "a person with an AUD" rather than "an alcoholic." Moreover, the word "alcoholic" should not be used as an adjective; for instance, the term "alcohol-associated liver disease" should be used instead of "alcoholic liver disease," to lessen the potential impact of stigma on care for people with liver disease, including those in need of a liver transplant [13].…”

The stigma of alcohol-related liver disease and its impact on healthcare

“…57,59 The different handling of people with ALD and with alcoholunrelated fatty liver disease has also been identified as a sign of structural stigma, wherein the former group has to fulfil harsher criteria to be eligible for liver transplantation. 60 If AUD is not recognised as a condition warranting specialist treatment, the frequent lack of cooperation between psychiatry and hepatology in the care of patients with ALD 54 could also signify structural stigma. In fact, many patients with ALD receiving pre-or post-transplant treatment described a lack of integration of addiction services into the liver transplant programme.…”

“…Because they are held personally responsible for their conditions, people with ALD are seen as less deserving of limited healthcare resources. 38,60 It is well established that AUD should be seen as a chronic relapsing condition in many patients, particularly with severe AUD, that may require life-long management, similar to other lifestylerelated disorders like type 2 diabetes, hypertension and obesity. 28 Many causal factors for alcohol-related disorders are beyond individual control, such as societal factors like alcohol acceptability, laws and regulatory frameworks, availability and affordability of alcohol, marketing and promotion, socio-economic factors like access to education and healthcare, housing conditions, social inequality or all forms of discrimination, or individual factors like traumatic experiences, genetic predisposition or concurrent mental disorders.…”

Stigmatization of drinking patients with liver cancer: The role of socioeconomic status

“…The concept of personal responsibility is at the heart of stigmatization [ 30 ], especially in liver diseases [ 31 , 32 ]. Indeed, according to the attribution theory, individuals have more stigmatizing attitudes towards persons with cancer if they identify behaviors that might be responsible for the disease, a situation that can be found in substance use behaviors [ 33 , 34 ], especially alcohol [ 31 ].…”

“…The development of effective screening campaigns is crucial [ 46 ], given that regular screening could significantly reduce liver cancer-related mortality [ 47 ]. Therefore, it seems necessary to counterbalance stigmatizing attitudes towards people with liver disease, especially in the healthcare context [ 30 ]. However, achieving this goal would first require to identify factors influencing the stigmatization around liver cancer and drinking.…”