Stigma Surrounding People with Substance Use Disorder: A Scoping Review Examining Educational Programs

Stigma is a powerful social determinant of substance use disorder (SUD) and can undermine recovery efforts among people who have developed SUD. Stigma awareness and reduction education is an essential component to prepare nurses and healthcare providers who provide care to people with SUD; however, the types and quality of stigma awareness and reduction educational programs is not well documented in the literature. Understanding the current literature on stigma awareness/reduction education can be a first step to bridging the gap to promote evidence-based educational programs. The purpose of this scoping review is to identify what educational programs are being used to train individuals about stigma toward people with SUD.

A comprehensive search using CINAHL, PubMed, PsycINFO, and Web of Science was conducted. Articles (n = 1,099) were uploaded to JBI SUMARI and two rounds of review (title and abstract review; n = 1,099) and full-text review; n = 450) were complete. Eighty-six articles were included in the extraction table. A preliminary codebook was developed. Content analysis was conducted by two researchers independently. The researchers met and discussed the analysis until a consensus was reached.

Findings were organized into the following categories related to educational programs: curriculum (content development, instrument development and testing, program evaluation); scope; and intended audience. While many learning programs hold great potential and have valuable elements to addressing stigma, one program was identified that meets all the criteria for an evidence-based, sustainable program focused on stigma awareness/reduction for healthcare professionals. This study included only first-year medical students and was not tested on other healthcare professionals.

These findings can inform evidence-based program development and evaluation. Stigma awareness/reduction education could be standardized and broadly disseminated to reach nurses, healthcare professionals and the community at large. This type of education could positively impact people with SUD.