Hospital-Based Stigma Practices Towards Individuals With Opioid Use Disorder: A Qualitative Study in Austin, Texas

Area of Science:

• Healthcare quality
• Patient experience
• Addiction medicine

Background:

• Individuals with opioid use disorder (OUD) frequently encounter stigma within healthcare settings.
• Stigma experienced in hospitals is linked to poorer treatment outcomes for OUD patients.
• Understanding provider-based stigmatizing practices is crucial for improving care.

Purpose of the Study:

• To explore stigma and positive care experiences of individuals with OUD in hospital settings.
• To identify specific hospital-based care practices that are stigmatizing or non-stigmatizing.
• To inform the development of improved hospital-based care for OUD patients.

Main Methods:

• Qualitative study utilizing semi-structured, in-person focus groups.
• Participants were individuals in recovery from opioid use disorder recruited via a community organization in Austin, TX (n=18).
• Applied thematic analysis was used to systematically categorize themes from discussions on healthcare experiences.

Main Results:

• Stigmatizing practices included non-person-first language, pain dismissal, labeling as "drug-seeking," and devaluing patient expertise.
• These practices led to fear of care, distrust, and internalized stigma among patients.
• Positive practices like recovery-oriented language, politeness, and shared decision-making fostered open communication and trust.

Conclusions:

• Hospital-based stigma significantly impacts patients with opioid use disorder.
• Hospital systems need to implement policies promoting patient-centered and non-stigmatizing practices.
• Improving care delivery for OUD patients requires addressing and eliminating stigmatizing care practices.