Perceptions of structural and provider-based substance use stigma interventions among primary care professionals

Area of Science:

• Health Services Research
• Public Health
• Addiction Medicine

Background:

• Stigma in primary care settings creates barriers for people who use drugs (PWUD).
• Limited understanding exists regarding the acceptability of interventions targeting structural stigma at organizational and provider levels.

Purpose of the Study:

• To explore perceptions of substance-use stigma among primary care staff.
• To assess the acceptability of potential interventions to mitigate stigma toward PWUD in primary care.

Main Methods:

• In-depth interviews with 21 clinical and non-clinical staff in Michigan primary care facilities.
• Thematic analysis to identify stigma themes and intervention acceptability.

Main Results:

• Staff often viewed stigma as individual attitudes, not structural issues.
• Interventions addressing knowledge gaps or improving care quality were supported.
• Some interventions were opposed due to perceived infeasibility (e.g., insurance/regulatory constraints).

Conclusions:

• While staff often conceptualize stigma individually, awareness of social determinants fosters openness to structural interventions.
• Primary care settings may be receptive to interventions reducing organizational and provider stigma toward PWUD.