Stigma Associated with Substance Use Disorders

Rural communities are taking different approaches to address the stigma associated with substance use disorders (SUD) and behavioral healthcare. In small rural communities, people with an SUD may avoid seeking treatment due to lack of anonymity and the stigma associated with asking for help and receiving health services. Some rural SUD programs are integrating behavioral health services into primary care settings, which allows patients to receive behavioral health screenings and referrals during their regularly scheduled primary care visits. If the behavioral health and primary care services function in a co-location model, patients can also receive behavioral health services at their primary care location, instead of traveling to a separate location. Offering behavioral health services within the primary care setting improves accessibility for rural communities and normalizes behavioral healthcare as a routine health service.

The criminalization of substance use also contributes to stigma for those with SUD. Some rural communities are addressing stigma by educating community members about the causes of SUD and enacting Good Samaritan protections at the local level. These protections may help to reduce concerns about the legal implications of calling for emergency medical services or helping someone who is overdosing. Further, rural programs are conducting trainings and providing technical assistance to healthcare providers to help them support people with SUDs.

The Rural Community Action Guide suggests four action steps to help address SUD-related stigma in rural communities:

1. Understand the portfolio of SUD research to mitigate stigma and support evidence-based treatment.
2. Educate the community about the science of SUDs by disseminating resources and educational materials.
3. Create and implement a tailored marketing plan to reduce stigma. Understand the stigma concerns, the best way to reach the community, and create a campaign to address stigma.
4. Disseminate positive recovery stories to support the recovery community.

When treating patients with SUDs, it is important for program staff and the community to understand that addiction is a chronic illness. Programs can implement practices to reduce stigma and ensure they do not perpetuate stigma surrounding SUD. These strategies include:

• 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

Language also matters in reducing stigma and establishing positive relationships with patients. It is recommended that programs use person-first language and other non-stigmatizing language that reflects an evidence-based understanding of SUD. Language evolves over time, so programs may need to continuously review best practices to stay up to date on current preferred language.

To learn more about mental health stigma in rural communities, see the Mental Health in Rural Communities Toolkit.

Resources to Learn More

Stigma: Beyond the Numbers
Website
Provides tips and learning resources to reduce stigma related to substance use disorders.
Organization(s): Centers for Disease Control and Prevention