Addressing Stigma for Rural MOUD Programs
Rural programs may need to address stigma regarding opioid use disorder (OUD) and use of medications
to treat OUD. Rural programs providing medication for opioid use disorder (MOUD) may encounter
types of stigma:
- Individualized stigma refers to negative thoughts and feelings experienced by the
person with OUD that may result in an avoidance of treatment.
- Social stigma refers to public views of and attitudes toward individuals with OUD
and may result in prejudice and labels towards those individuals.
- Provider stigma refers to negative perceptions among healthcare providers and
staff regarding patients with OUD and cultural norms regarding use of medication to treat OUD, and
may influence MOUD adoption within treatment settings.
The American Medical Association has identified
four factors that contribute to provider stigma regarding MOUD:
Use of stigmatizing language
Perceiving OUD as a choice or weakness, rather than a medical illness
Treating OUD separately from other health issues, making it difficult to integrate and coordinate
Lack of access to MOUD for incarcerated populations
When treating patients with substance use disorders, including OUD, it is important for program staff
and the community to understand that addiction
is a chronic illness. There are practices
programs can implement to reduce stigma and ensure they do not perpetuate stigma surrounding substance
use disorder. These practices include:
Using person-first language. The National Institute on Drug Abuse has also created a
list of stigmatizing language often used when discussing people with substance use disorders and
provides alternative language to help mitigate stigma.
Discussing drug test results with patients rather than punishing them for relapsing.
Explaining that addiction is a chronic disease that can be treated with medications.
For medication-assisted treatment (MAT) and MOUD programs that also offer behavioral health services,
it is important to note that mental health and behavioral health services may add additional stigma,
particularly in rural areas. Program staff should explain that medication may just be one part of a
person's recovery and addressing mental and behavioral health may help some patients achieve a
For additional information about addressing stigma specific to rural substance use disorder programs,
see Stigma in the
Rural Prevention and Treatment of Substance Use Disorders Toolkit.
For additional information about addressing stigma specific to mental health in rural communities,
see Stigma in the Mental Health in Rural Communities Toolkit.
Resources to Learn More
Myths About Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD)
An infographic listing seven myths about MAT followed by evidence supporting the use of medications
to treat OUD.
Organization(s): National Council for Behavioral Health
for Opioid Use Disorder: Overcoming Objections
Provides answers to frequently asked questions and concerns regarding medication for opioid use disorder.
Author(s): Strugar-Fritsch, D
Organization(s): California Health Care Foundation (CHCF)