Stigma, discrimination and the health of illicit drug users.
- Authors
- Ahern, Jennifer; Stuber, Jennifer; Galea, Sandro
- Year
- 2007
- Journal
- Drug and alcohol dependence
- PMID
- 17118578
- DOI
- 10.1016/j.drugalcdep.2006.10.014
Persons who use illicit drugs are stigmatized in the United States. The conferral of a deviant social status on illicit drug users may serve to discourage use. However, stigmatization may also adversely affect the health of those who use illicit drugs, through exposure to chronic stress such as discrimination and as a barrier to accessing care. We hypothesized that aspects of stigma and discrimination would be associated with mental and physical health among illicit drug users. Using street outreach techniques, 1008 illicit drug users were interviewed about stigma and discrimination related to their drug use, and their health. We measured discrimination related to drug use, alienation, perceived devaluation, and responses to discrimination and stigma. Health measures included mental and physical health measures from the Medical Outcomes Study Short Form-36, depression symptoms from the Center for Epidemiological Studies Depression scale, and a sum of health conditions. In adjusted models, discrimination and alienation were both associated with poorer mental health, and only discrimination was associated with poorer physical health. Angry responses to discrimination and stigma were associated with poorer mental health. The association of stigma and discrimination with poor health among drug users suggests the need for debate on the relative risks and benefits of stigma and discrimination in this context.
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| Psychological distress mediated the effects of self-stigma on quality of life in opioid-dependent individuals: A cross-sectional study. | Chang KC et al. | — | 2019 | → |
| Self-care habits among people who inject drugs with skin and soft tissue infections: a qualitative analysis. | Gilbert AR et al. | — | 2019 | → |
| Sources of Stress among Adults with Co-occurring Drug Use and Depressive Symptoms. | Tormohlen KN et al. | — | 2019 | → |
| Stigma as a fundamental hindrance to the United States opioid overdose crisis response. | Tsai AC et al. | — | 2019 | → |
| Stigma, Discrimination, Treatment Effectiveness, and Policy Support: Comparing Behavior Analysts' Views on Drug Addiction and Mental Illness. | Rey CN et al. | — | 2019 | → |
| Stigma, Treatment, and Health among Stimulant Users: Life Stage as a Moderator. | Woodhead EL et al. | — | 2019 | → |
| Strategies used by people who inject drugs to avoid stigma in healthcare settings. | Biancarelli DL et al. | — | 2019 | → |
| Substance Use Stigma and Antiretroviral Therapy Adherence Among a Drug-Using Population Living with HIV. | Stringer KL et al. | — | 2019 | → |
| Take-Home Naloxone for the Emergency Interim Management of Opioid Overdose: The Public Health Application of an Emergency Medicine. | Strang J et al. | — | 2019 | → |
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| The Dark Side of Addiction Support Forums: Impacts of Poor Quality and Insufficient Emotional Support on Perceived Support Availability and Health Efficacy. | Malloch YZ et al. | — | 2019 | → |
| The Discrimination Against, Health Status and Wellness of People Who Use Drugs in Italian Services: A Survey. | Pelullo CP et al. | — | 2019 | → |
| The value of unsolicited online data in drug policy research. | Enghoff O et al. | — | 2019 | → |
| "We don't get much of a voice about anything": perspectives on photovoice among people who inject drugs. | Drainoni ML et al. | — | 2019 | → |
| A Longitudinal Analysis of Daily Pill Burden and Likelihood of Optimal Adherence to Antiretroviral Therapy Among People Living With HIV Who Use Drugs. | Mohd Salleh NA et al. | — | 2018 | → |
| Availability of HIV and HCV On-Site Testing and Treatment at Syringe Service Programs in the United States. | Behrends CN et al. | — | 2018 | → |
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| Beyond interferon side effects: What residual barriers exist to DAA hepatitis C treatment for people who inject drugs? | Madden A et al. | — | 2018 | → |
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| Experiences with skin and soft tissue infections among people who inject drugs in Philadelphia: A qualitative study. | Harris RE et al. | — | 2018 | → |
| Experimental Investigation of Implicit HIV and Preexposure Prophylaxis Stigma: Evidence for Ancillary Benefits of Preexposure Prophylaxis Use. | Golub SA et al. | — | 2018 | → |
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| Frequent experience of discrimination among people who inject drugs: Links with health and wellbeing. | Couto E Cruz C et al. | — | 2018 | → |
| Health workers' support for hepatitis C treatment uptake among clients with a history of injecting. | Brener L et al. | — | 2018 | → |
| Implicit and explicit internalized stigma: Relationship with risky behaviors, psychosocial functioning and healthcare access among people who inject drugs. | von Hippel C et al. | — | 2018 | → |
| Injection drug use and overdose among young adults who use prescription opioids non-medically. | Liebling EJ et al. | — | 2018 | → |
| Injection drug use, HIV/HCV, and related services in nonurban areas of the United States: A systematic review. | Paquette CE et al. | — | 2018 | → |
| Neuromodulation for substance addiction in human subjects: A review. | Bari A et al. | — | 2018 | → |
| Perceived discrimination, racial identity, and health behaviors among black primary-care patients who use drugs. | Squires LE et al. | — | 2018 | → |
| Perceived support for medical cannabis use among approved medical cannabis users in Canada. | Leos-Toro C et al. | — | 2018 | → |
| Preliminary psychometric evaluation of the micro-condescension scale for individuals in substance use treatment. | Grigsby TJ et al. | — | 2018 | → |
| Serotonergic psychedelics and personality: A systematic review of contemporary research. | Bouso JC et al. | — | 2018 | → |
| Stigma at every turn: Health services experiences among people who inject drugs. | Paquette CE et al. | — | 2018 | → |
| Symbolic perceptions of methamphetamine: Differentiating between ice and shake. | Copes H et al. | — | 2018 | → |
| The Affordable Care Act and Changes in Insurance Coverage and Source of Health Care among High-risk Rural, Substance-using, Female Offenders Transitioning to the Community. | Dickson MF et al. | — | 2018 | → |
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| Associations Between Physical Pain, Pain Management, and Frequency of Nonmedical Prescription Opioid Use Among Young Adults: A Sex-specific Analysis. | Evans TI et al. | — | 2017 | → |
| A sympathetic nervous system evaluation of obesity stigma. | Oliver MD et al. | — | 2017 | → |
| Avatar-assisted therapy: a proof-of-concept pilot study of a novel technology-based intervention to treat substance use disorders. | Gordon MS et al. | — | 2017 | → |
| Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention. | Walters SM et al. | — | 2017 | → |
| Computer tablet or telephone? A randomised controlled trial exploring two methods of collecting data from drug and alcohol outpatients. | Hobden B et al. | — | 2017 | → |
| Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the Mental Health Stigma Literature. | Corrigan P et al. | — | 2017 | → |
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| Differential experiences of Mexican policing by people who inject drugs residing in Tijuana and San Diego. | Wood EF et al. | — | 2017 | → |
| Disparities in direct acting antivirals uptake in HIV-hepatitis C co-infected populations in Canada. | Saeed S et al. | — | 2017 | → |
| Drug use Discrimination Predicts Formation of High-Risk Social Networks: Examining Social Pathways of Discrimination. | Crawford ND et al. | — | 2017 | → |
| Evaluation of an online injecting drug use stigma intervention targeted at health providers in New South Wales, Australia. | Brener L et al. | — | 2017 | → |
| Gender Differences in Factors Related to HIV Risk Behaviors among People Who Inject Drugs in North-East India. | Sabri B et al. | — | 2017 | → |
| General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil. | Ventura CAA et al. | — | 2017 | → |
| HIV-Related Stigma and Overlapping Stigmas Towards People Living With HIV Among Health Care Trainees in Canada. | Wagner AC et al. | — | 2017 | → |
| Medical Disease or Moral Defect? Stigma Attribution and Cultural Models of Addiction Causality in a University Population. | Henderson NL et al. | — | 2017 | → |
| Perceived Devaluation and STI Testing Uptake among a Cohort of Street-Involved Youth in a Canadian Setting. | Karamouzian M et al. | — | 2017 | → |
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| Preparing Nursing Students to Work With Patients With Alcohol or Drug-Related Problems. | Nash AJ et al. | — | 2017 | → |
| Sexual risk behaviors and predictors of inconsistent condom use among crack cocaine users in the French overseas territories in the Americas. | Parriault MC et al. | — | 2017 | → |
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| Stereotype threat and social function in opioid substitution therapy patients. | von Hippel C et al. | — | 2017 | → |
| Stigmatization among methadone maintenance treatment patients in mountainous areas in northern Vietnam. | Van Nguyen H et al. | — | 2017 | → |
| Syndemic Risk Classes and Substance Use Problems among Adults in High-Risk Urban Areas: A Latent Class Analysis. | Cleland CM et al. | — | 2017 | → |
| The Role of Internalized Stigma in the Disclosure of Injecting Drug Use Among People Who Inject Drugs and Self-Report as HIV-Positive in Kohtla-Järve, Estonia. | Johannson A et al. | — | 2017 | → |
| Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults. | Seelman KL et al. | — | 2017 | → |
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| A comparison of recreational drug use amongst sexual health clinic users in London with existing prevalence data. | Thurtle N et al. | — | 2016 | → |
| A new era of addiction treatment amplifies the stigma of disease and treatment for individuals with obesity. | Alfaris N et al. | — | 2016 | → |
| Attitudes, practices, and preparedness to care for patients with substance use disorder: Results from a survey of general internists. | Wakeman SE et al. | — | 2016 | → |
| Depression Among People Who Inject Drugs and Their Intimate Partners in Kazakhstan. | Shaw SA et al. | — | 2016 | → |
| Drug addiction stigma in relation to methadone maintenance treatment by different service delivery models in Vietnam. | Tran BX et al. | — | 2016 | → |
| Experienced and anticipated discrimination reported by individuals in treatment for substance use disorders within the Netherlands. | van Boekel LC et al. | — | 2016 | → |
| Experiences of Discrimination and HIV Risk Among Men Who Have Sex With Men in New York City. | Reilly KH et al. | — | 2016 | → |
| Exploring Service Provider Perceptions of Treatment Barriers Facing Black, Non-Gay-Identified MSMW. | Forenza B et al. | — | 2016 | → |
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| Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment. | Dyb E | — | 2016 | → |
| Individual and Neighborhood Characteristics Associated with HIV Among Black and Latino Adults Who Use Drugs and Unaware of Their HIV-Positive Status, New York City, 2000-2004. | Lewis CF et al. | — | 2016 | → |
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| "Not human, dead already": Perceptions and experiences of drug-related stigma among opioid-using young adults from the former Soviet Union living in the U.S. | Gunn A et al. | — | 2016 | → |
| Parent's alcoholism severity and family topic avoidance about alcohol as predictors of perceived stigma among adult children of alcoholics: Implications for emotional and psychological resilience. | Haverfield MC et al. | — | 2016 | → |
| Pharmacotherapy for Substance Use Disorders. | Klein JW | — | 2016 | → |
| Stigma in Cirrhotic Patients: A Qualitative Study. | Shabanloei R et al. | — | 2016 | → |
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| Substance use stigma: Reliability and validity of a theory-based scale for substance-using populations. | Smith LR et al. | — | 2016 | → |
| The issue of being touched. | Solvoll BA et al. | — | 2016 | → |
| Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs. | Treloar C et al. | — | 2016 | → |
| An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential. | Perlman DC et al. | — | 2015 | → |
| Black-White Latino Racial Disparities in HIV Survival, Florida, 2000-2011. | Sheehan DM et al. | — | 2015 | → |
| Cultural model of self-stigma among Chinese with substance use problems. | Mak WW et al. | — | 2015 | → |
| Discrimination by health care workers versus discrimination by others: countervailing forces on HCV treatment intentions. | Brener L et al. | — | 2015 | → |
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| Exploring the experience of chronic pain among female Survival Sex Workers: a qualitative study. | Allen C et al. | — | 2015 | → |
| Factors that influence mother-child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia. | Doab A et al. | — | 2015 | → |
| Health Culture and Running: Non-Elite Runners' Understandings of Doping and Supplementation. | Henning AD | — | 2015 | → |
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| HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador. | Dickson-Gomez J et al. | — | 2015 | → |
| Impacts of stigma on HIV risk for women who inject drugs in Java: A qualitative study. | Spooner C et al. | — | 2015 | → |
| Intra-group Stigma: Examining Peer Relationships Among Women in Recovery for Addictions. | Gunn AJ et al. | — | 2015 | → |
| Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders. | Leung KS et al. | — | 2015 | → |
| Responsible and controlled use: Older cannabis users and harm reduction. | Lau N et al. | — | 2015 | → |
| Social functioning and internalized stigma in individuals diagnosed with substance use disorder. | Can G et al. | — | 2015 | → |
| Stigma among California's Medical Marijuana Patients. | Satterlund TD et al. | — | 2015 | → |
| The impact of knowledge on attitudes of emergency department staff towards patients with substance related presentations: a quantitative systematic review protocol. | Clarke DE et al. | — | 2015 | → |
| The impact of pluralistic ignorance on the provision of health care for people who inject drugs. | Brener L et al. | — | 2015 | → |
| The interplay between drug-use behaviors, settings, and access to care: a qualitative study exploring attitudes and experiences of crack cocaine users in Rio de Janeiro and São Paulo, Brazil. | Krawczyk N et al. | — | 2015 | → |
| The role of Aboriginal community attachment in promoting lifestyle changes after hepatitis C diagnosis. | Brener L et al. | — | 2015 | → |
| The role of visual markers in police victimization among structurally vulnerable persons in Tijuana, Mexico. | Pinedo M et al. | — | 2015 | → |
| 'They don't look at what affects us': the role of ecodevelopmental factors on alcohol and drug use among Latinos with physical disabilities. | Cordova D et al. | — | 2015 | → |
| Toward cultural safety: nurse and patient perceptions of illicit substance use in a hospitalized setting. | Pauly BB et al. | — | 2015 | → |
| Ultra-structural hair alterations of drug abusers: a scanning electron microscopic investigation. | Turkmenoglu FP et al. | — | 2015 | → |
| An assessment of health-care students' attitudes toward patients with or at high risk for HIV: implications for education and cultural competency. | Jin H et al. | — | 2014 | → |
| Care and prejudice: moving beyond mistrust in the care relationship with addicted patients. | Reyre A et al. | — | 2014 | → |
| Contested space in the pharmacy: public attitudes to pharmacy harm reduction services in the West of Scotland. | Gidman W et al. | — | 2014 | → |
| Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings. | Skosireva A et al. | — | 2014 | → |
| Differential experiences of discrimination among ethnoracially diverse persons experiencing mental illness and homelessness. | Zerger S et al. | — | 2014 | → |
| Eligibility of persons who inject drugs for treatment of hepatitis C virus infection. | Arain A et al. | — | 2014 | → |
| Evaluating the impact of Mexico's drug policy reforms on people who inject drugs in Tijuana, B.C., Mexico, and San Diego, CA, United States: a binational mixed methods research agenda. | Robertson AM et al. | — | 2014 | → |
| Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities. | Quinn DM et al. | — | 2014 | → |
| Impact of conjoint trajectories of body mass index and marijuana use on short sleep duration. | Brook JS et al. | — | 2014 | → |
| Perceived discrimination and injecting risk among people who inject drugs attending Needle and Syringe Programmes in Sydney, Australia. | Wilson H et al. | — | 2014 | → |
| Preferences for policy options for cannabis in an Australian general population: A discrete choice experiment. | Shanahan M et al. | — | 2014 | → |
| Problem drinking's associations with social structure and mental health care: race/ethnicity differences. | Lo CC et al. | — | 2014 | → |
| Psychiatric comorbidity and perceived alcohol stigma in a nationally representative sample of individuals with DSM-5 alcohol use disorder. | Glass JE et al. | — | 2014 | → |
| Racial/Ethnic Differences in Recent Drug Detoxification Enrollment and the Role of Discrimination and Neighborhood Factors. | Crawford ND et al. | — | 2014 | → |
| Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men. | Kao D et al. | — | 2014 | → |
| Stigma among Individuals with Substance Use Disorders: Does it Predict Substance Use, and Does it Diminish with Treatment? | Kulesza M et al. | — | 2014 | → |
| Stigma as a public health tool: implications for health promotion and citizen involvement. | Williamson L et al. | — | 2014 | → |
| Stigma predicts residential treatment length for substance use disorder. | Luoma JB et al. | — | 2014 | → |
| Stigmatization of people with drug dependence in China: a community-based study in Hunan province. | Luo T et al. | — | 2014 | → |
| Thai men's experiences of alcohol addiction and treatment. | Hanpatchaiyakul K et al. | — | 2014 | → |
| The relationship between discrimination and high-risk social ties by race/ethnicity: examining social pathways of HIV risk. | Crawford ND et al. | — | 2014 | → |
| The Relationship Between Multiple Forms of Discrimination, Neighborhood Characteristics, and Depression Among Illicit Drug Users in New York City. | Crawford ND et al. | — | 2014 | → |
| A human rights view on access to controlled substances for medical purposes under the international drug control framework. | Gispen MEC | — | 2013 | → |
| Alcohol and drug use disorders among patients with myocardial infarction: associations with disparities in care and mortality. | Beck CA et al. | — | 2013 | → |
| Alcohol stigma and persistence of alcohol and other psychiatric disorders: a modified labeling theory approach. | Glass JE et al. | — | 2013 | → |
| Chapter 7. Narrative stories and discourses in an interview with a former amphetamine user. | Lilja M | — | 2013 | → |
| Client and staff experiences of a co-located service for hepatitis C care in opioid substitution treatment settings in New South Wales, Australia. | Treloar C et al. | — | 2013 | → |
| Concealable Stigmatized Identities and Psychological Well-Being. | Quinn DM et al. | — | 2013 | → |
| Differences in HIV risk behavior of injection drug users in New York City by health care setting. | Turner AK et al. | — | 2013 | → |
| Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma. | Earnshaw V et al. | — | 2013 | → |
| Knowledge and attitudes towards hepatitis C and injecting drug use among mental-health support workers of a community managed organisation. | Rose G et al. | — | 2013 | → |
| 'Makes you wanna do treatment': benefits of a hepatitis C specialist clinic to clients in Christchurch, New Zealand. | Brener L et al. | — | 2013 | → |
| Mental illness stigma, help seeking, and public health programs. | Henderson C et al. | — | 2013 | → |
| Perceptions of cannabis as a stigmatized medicine: a qualitative descriptive study. | Bottorff JL et al. | — | 2013 | → |
| Profiles of quality of life in opiate-dependent individuals after starting methadone treatment: a latent class analysis. | De Maeyer J et al. | — | 2013 | → |
| Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers. | Lang K et al. | — | 2013 | → |
| Quality of life of people who inject drugs: characteristics and comparisons with other population samples. | Fischer JA et al. | — | 2013 | → |
| Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments. | Ozkaynak M et al. | — | 2013 | → |
| Self-Stigma in Substance Abuse: Development of a New Measure. | Luoma JB et al. | — | 2013 | → |
| Substance Use Related Stigma: What we Know and the Way Forward. | Kulesza M et al. | — | 2013 | → |
| The influence of neighborhood characteristics on the relationship between discrimination and increased drug-using social ties among illicit drug users. | Crawford ND et al. | — | 2013 | → |
| The influence of uncertainty and social support on information seeking concerning illicit stimulant use among young adults. | Morse CR et al. | — | 2013 | → |
| The relationship between drug user stigma and depression among inner-city drug users in Baltimore, MD. | Latkin C et al. | — | 2013 | → |
| The relationship between perceived discrimination and high-risk social ties among illicit drug users in New York City, 2006-2009. | Crawford ND et al. | — | 2013 | → |
| The Role of Intrapersonal Factors on Alcohol and Drug Use Among Latinos With Physical Disabilities. | Cordova D et al. | — | 2013 | → |
| Understanding barriers to hepatitis C virus care and stigmatization from a social perspective. | Treloar C et al. | — | 2013 | → |
| A pilot study examining perceived rejection and secrecy in relation to illicit drug use and associated stigma. | Palamar JJ | — | 2012 | → |
| Comparison of Objective Screening and Self-Report for Alcohol and Drug Use in Traumatically Injured Patients. | Sakai LM et al. | — | 2012 | → |
| Differences in self-reported discrimination by primary type of drug used among New York City drug users. | Crawford ND et al. | — | 2012 | → |
| Factors associated with experiences of stigma in a sample of HIV-positive, methamphetamine-using men who have sex with men. | Semple SJ et al. | — | 2012 | → |
| From personal tragedy to personal challenge: responses to stigma among sober living home residents and operators. | Heslin KC et al. | — | 2012 | → |
| Psychometric assessment of scales measuring HIV public stigma, drug-use public stigma and fear of HIV infection among young adolescents and their parents. | Ha TH et al. | — | 2012 | → |
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| Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan. | Lee TS et al. | — | 2011 | → |
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| Social exclusion, personal control, self-regulation, and stress among substance abuse treatment clients. | Cole J et al. | — | 2011 | → |
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| Stigmatizing Clients with Mental Health Conditions: An Assessment of Social Work Student Attitudes. | Kubiak SP et al. | — | 2011 | → |
| The vicious circle of perceived stigmatization, depressiveness, anxiety, and low quality of life in substituted heroin addicts. | Frischknecht U et al. | — | 2011 | → |
| Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. | Kelly JF et al. | — | 2010 | → |
| "Fitness for duty": social, organisational and structural influences on the design and conduct of candidate hepatitis C vaccine trials involving people who inject drugs. | Treloar C et al. | — | 2010 | → |
| Preventing opiate overdose deaths: examining objections to take-home naloxone. | Bazazi AR et al. | — | 2010 | → |
| The relationship between drug use stigma and HIV injection risk behaviors among injection drug users in Chennai, India. | Latkin C et al. | — | 2010 | → |
| The role of physician and nurse attitudes in the health care of injecting drug users. | Brener L et al. | — | 2010 | → |
| Achieving professional practice change: from training to workforce development. | Roche AM et al. | — | 2009 | → |
| Adolescent stigma towards drug addiction: effects of age and drug use behaviour. | Adlaf EM et al. | — | 2009 | → |
| Nowhere to go: how stigma limits the options of female drug users after release from jail. | van Olphen J et al. | — | 2009 | → |
| Perceived discrimination and health: a meta-analytic review. | Pascoe EA et al. | — | 2009 | → |
| Stigma reported by nurses related to those experiencing drug and alcohol dependency: a phenomenological Giorgi study. | Lovi R et al. | — | 2009 | → |
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| Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico. | Strathdee SA et al. | — | 2008 | → |
| Psychosocial and behavioral correlates of depressed mood among female methamphetamine users. | Semple SJ et al. | — | 2007 | → |
| What we can learn from the INSPIRE Study about improving prevention and clinical care for injection drug users living with HIV. | Jones TS et al. | — | 2007 | → |