Several studies have identified stigma as a significant barrier for accessing health care and substance use treatment services [31,44–47]. Health-care providers may hold negative beliefs about people with substance use disorders, including that they overuse system resources, are not vested in their own health, abuse the system through drug-seeking and diversion and fail to adhere to recommended care [7,48]. Such perceptions can contribute to inequitable and poor provision of care for people with these disorders. As such, individuals with substance use disorders may choose to conceal their substance use problems to avoid stigma, which may result in care provision that does not attend to substance use-related needs (e.g. while pregnant) [33]. The stereotypes associated with substance use treatment services themselves (i.e. methadone maintenance, residential treatment) can also lower the likelihood that people will engage in services [46]. Similarly, health-care providers may refuse to offer certain services (e.g. needle exchange) or may not prescribe effective pharmacological treatments to patients suffering from other illnesses (e.g. cancer, back pain) on account of stigma [49–52].
