Substance use stigma: Reliability and validity of a theory-based scale for substance-using populations

Area of Science:

• Psychiatry and Behavioral Sciences
• Public Health
• Health Services Research

Background:

• Substance use disorders are highly stigmatized globally, leading to health inequities and hindering treatment.
• Existing measures of substance use stigma are insufficient.
• Stigma theory provides a framework for understanding and measuring stigma's impact.

Purpose of the Study:

• To develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS).
• To capture enacted, anticipated, and internalized stigma experienced by individuals with substance use disorders.
• To differentiate between key sources of stigma, such as family and healthcare providers.

Main Methods:

• Cross-sectional evaluation of the SU-SMS.
• Assessment of validity, reliability, and generalizability.
• Utilized two independent samples with diverse substance use and treatment histories.

Main Results:

• The SU-SMS demonstrated structural and construct validity.
• The scale successfully captured distinct types of stigma (enacted, anticipated, internalized).
• It differentiated between stigma from family and healthcare providers and correlated with health outcomes, showing high reliability and generalizability.

Conclusions:

• The SU-SMS is a valuable tool for assessing stigma mechanisms in substance use disorders.
• It can enhance understanding of how stigma affects health behaviors and outcomes.
• This scale can inform interventions to mitigate the impact of stigma.