Targeting Addiction Structural Stigma Embodied in Law ("TASSEL"): Findings from an intrastate legal mapping study

Stigma is a fundamental cause of disease that reflects and intensifies health inequalities. Laws are powerful mediators for stigma; to correct them, it is critical to know which laws promote stigma. This paper deploys legal epidemiology methods to map addiction stigma in California law. Robust policy surveillance methods can assist policymakers in identifying stigmatizing laws, providing a path to their remediation.

The study utilizes a vertical/intrastate legal mapping design to produce a dataset mapping stigma-promoting and stigma-inhibiting laws in California at state, county, and municipal levels. Tracking legal epidemiologic methods, the study moved through five distinct phases to harvest legal data, code it, analyze it, resolve discrepancies, and perfect the legal dataset.

Every jurisdiction surveyed maintains laws that promote stigma against persons with addiction. The most common categories of such laws include employment-based restrictions and laws that restrict specified social spaces with respect to substance use (i.e., zoning laws, nuisance designations). Many jurisdictions also include legislative findings that promote stigma against persons with addiction.

Because laws are powerful mediators of structural stigma, they present important opportunities for anti-stigma work. Developing methods for mapping stigma-promoting laws is critical to policy surveillance that can serve anti-stigma and equity-advancing practice.