Stigma creates obstacles to opioid dependency treatment

Feb 29, 2024

A recent opinion article authored by Dr. Mark S. Gould and published by Psychology Today discusses the impact of negative attitudes and stigma towards individuals affected by opioid use disorder on their access to treatment.

According to Dr. Gould, stigma can contribute to the low rate (1 in 5) of individuals with opioid dependence disorder receiving approved medications for their treatment in the U.S.

The results of a research study published in the journal Psychiatric Services, which surveyed 1000 participants, showed that 78% of respondents said individuals addicted to prescription opioids were to blame for their own addiction, while 72% said some people lack sufficient self-discipline to use prescribed opioids without developing an addiction. In addition, 56% of respondents said that people addicted to prescription opioids were more dangerous than others.

Moreover, another study of approximately 700 respondents showed that participants’ attitudes were significantly more negative toward people with addiction compared to people with mental illness,  with 78% of participants stating they would not be willing to work with a person with a drug addiction, while 38% of participants said they would not be willing to work with an individual with a mental illness.

In his opinion article, Dr. Gould also noted that negative attitudes towards individuals suffering from opioid dependence disorder also persist among medical professionals, with many primary care physicians choosing to not prescribe drugs such as Suboxone or extended-release naltrexone to patients diagnosed with opioid use disorder.

“There is also a lack of awareness about treatment medications. One commonly held belief is that prescribing treatment medication is merely substituting one drug for another. Yet naltrexone contains no opioids, essentially makes people who take it immune to opioids, and is not a scheduled drug,” writes Dr. Gould.

Dr. Gould also highlighted the fact that many physicians are reluctant to treat patients with opioid use disorder. One research study surveying 1,000 primary care physicians and 1,000 physician trainees (residents) found that only 20% of the experienced physicians said they would be willing to treat individuals with opioid use dependence using approved treatment, compared to nearly 50% of the trainees who said they would provide such treatment.

Furthermore, Dr. Gould also added that individuals with opioid use disorder and other forms of substance dependence often adopt the public’s negative attitude toward people dependent on opioids.

“Stigmatization against people dependent on drugs, particularly opioids, is prevalent and extends to many physicians who could treat such individuals but choose not to, such as emergency room or primary care providers. Despite increased funding for medicines to treat OUD, the training of physicians and others to prescribe treatments for OUD, and increased access to Narcan, shame and stigma appear as root causes of the continued epidemic of deaths from opioid overdoses, Recognizing and fighting back against the stigma is the best way to reverse the continuing, shocking number of deaths from opioid overdose,” he concluded.