Enacted Stigma from Family and Drug Use during Opioid Use Disorder Treatment

Enacted stigma (i.e., experiences of discrimination from others) is associated with engagement in drug use among people with a wide range of stigmatized statuses. This association may be particularly concerning among people receiving treatment for opioid use disorder (OUD), among whom continued drug use may undermine treatment outcomes and increase risk of overdose. Although past research largely overlooks the source of enacted stigma, theory and qualitative findings suggest that stigma from family members may be particularly harmful. The current study therefore explores whether enacted stigma experienced from family members is associated with greater engagement in drug use than stigma from other sources among people engaged in OUD treatment. Quantitative data were collected from n=145 people receiving treatment for OUD. Participants reported on experiences of enacted stigma from a total of k=190 other people. Drug use was indicated by positive urinalysis test screens. Data were analyzed using general linear mixed models. Results suggest that enacted stigma from family members is more strongly associated with drug use among people engaged in OUD treatment than enacted stigma from other sources. Future research should continue to explore the role of different types of relationships in associations between enacted stigma and drug use, especially among people engaged in OUD treatment. If findings are replicated, interventions should seek to address stigma from family in particular to promote the recovery efforts of people with OUD.