It's Not Denial, It's Stigma: A Case Study

Addictions nurses often encounter barriers to care for clients such as stigma, especially in settings outside addictions specialty care. This article utilizes a case-study format to show and discuss concepts related to client engagement in recovery and overcoming stigma. Laura, a 65-year-old woman, presents with a worsening of her alcohol use disorder in the setting of a recent retirement, worsening symptoms of major depressive disorder, and the stressors associated with the COVID-19 pandemic. She presents with her depression and is reluctant to discuss her alcohol use, after a past experience in a program that utilized a confrontational approach. Her primary care provider describes her as "in denial," but this case study will discuss elements including stigma, self-stigma, and the culture of addictions treatment and their impact on recovery. Finally, this presentation will describe how the addictions nurse can leverage a person-centered and recovery-oriented approach to promote engagement and positive problem solving with the client and the care team.