Opioid use-related stigma and health care decision-making

Psychol Addict Behav. 2023 Mar;37(2):222-227. doi: 10.1037/adb0000830. Epub 2022 Mar 28.

Abstract

Objective: Stigma is described as highly relevant to the treatment context for opioid use disorder (OUD) partly because it is known to influence providers' treatment decisions and care provision. However, further study is needed to directly test the salience of stigmatizing views for healthcare decision-making among providers, and particularly those including medication for opioid use disorder (MOUD). This study assessed whether stigma toward illicit opioid use was associated with a willingness to provide or refer patients for MOUD treatment among a sample of healthcare providers. It also evaluated variation in stigmatizing views as a function of familiarity with OUD and MOUD and provider type.

Method: Structural equation modeling was utilized to evaluate the antecedents and healthcare decision-making consequences associated with stigma based on survey data from a sample of 144 clinicians participating in a buprenorphine waiver training program (30% female).

Results: Providers who have less familiarity with OUD and MOUD and those who are medical students or residents are significantly more likely to endorse stigmatizing views of illicit opioid use. In turn, greater stigma is significantly associated with a lesser willingness to provide treatment or refer patients to MOUD treatment.

Conclusions: Further consideration of stigma is recommended in future research to improve clinical practice and increase the implementation of MOUD treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MeSH terms

  • Analgesics, Opioid
  • Buprenorphine* / therapeutic use
  • Delivery of Health Care
  • Female
  • Health Personnel
  • Humans
  • Male
  • Opiate Substitution Treatment
  • Opioid-Related Disorders* / drug therapy

Substances

  • Analgesics, Opioid
  • Buprenorphine

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