Correlates of Stigma Severity Among Persons Seeking Opioid Detoxification

Among people with opioid use disorder (OUD), stigma is a known barrier to accessing treatment and has negative impacts on physical and mental health. The purpose of this study was to understand the factors associated with self-stigma and perceived stigma severity among people with OUD entering an inpatient detoxification program.

Between December 2015 and August 2016, consecutive persons seeking inpatient opioid detoxification were asked to complete a survey that included sociodemographic, drug use, treatment variables, an 8-item General Self-Stigma scale, and a 3-item Treatment Stigma scale. Correlates of stigma severity were estimated using ordinary least squares regression.

The 407 participants had an average age of 32.4 (±8.79) years, with 72.2% male and 84.5% non-Hispanic White. Two-thirds had ever received medication-assisted treatment for OUD and 323 (79.4%) had ever been admitted to a detoxification program. Adjusted mean General Self-Stigma scores were positively and significantly associated with recent injection drug use (b = 0.262, P = 0.032), and having previously entered detoxification programs (b = 0.330, P = 0.016). Adjusted mean Treatment Stigma scores were positively and significantly associated with years of education (b = 0.142, P = 0.002), having ever been prescribed naltrexone (b = 0.277, P = 0.025) and having previously entered detoxification programs (b = 0.389, P = 0.007).

People with OUD presenting for inpatient detoxification struggle with experiences of self and perceived stigma. Strikingly, people with previous detoxification program admission had higher levels of stigma on both scales. Our findings suggest an opportunity for targeted intervention in this group.