Diversity in opioid-related stigma interventions: A systematic review

Area of Science:

• Public Health
• Health Equity
• Addiction Medicine

Background:

• Opioid use disorder (OUD) is a prevalent, stigmatized condition.
• Stigma creates significant barriers to OUD treatment engagement and retention.
• Marginalized communities face disproportionate OUD impacts and overdose risks.

Purpose of the Study:

• To review interventions targeting OUD-related stigma.
• To focus on the diversity and cultural relevance of these stigma reduction initiatives.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Searched for articles published up to May 2025 describing OUD stigma interventions.

Main Results:

• Most interventions targeted provider or public stigma.
• Demographic representation was inconsistent, with limited focus on race, ethnicity, gender identity, or sexual orientation.
• Sixty-eight percent of studies included cultural considerations, often by involving individuals with lived OUD experience.

Conclusions:

• This review highlights the need for culturally informed OUD stigma reduction.
• Gaps exist in sociodemographic data collection and tailored interventions for intersectional stigma.
• Future interventions require inclusive recruitment, intersectional frameworks, and community collaboration for diverse populations.