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Rural Health Information Hub

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 several 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 patient care
  • 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 sustainable recovery.

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

Challenging the 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
Date: 6/2019

MAT 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)
Date: 7/2019