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Leading researchers and people with lived experience explain the stigma of substance use disorders, and develop solutions for overcoming it.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Stigma and discrimination of people with substance use disorders (SUD) contribute massively to the harm done by their condition: stigma has negative effects on service engagement, life opportunities, and personal shame, both for those who struggle with substance abuse and their families. Overcoming the stigma of substance use disorders is essential to aid recovery in those with SUD. This book provides an in-depth understanding of the stigma of SUD, and proposes ways to overcome it in different settings from the criminal justice system to healthcare. Combining a multitude of viewpoints within a consistent theoretical framework, this book both summarizes the latest evidence and gives hands-on advice and future directions on how to combat the stigma of SUD. People with lived experience of SUD, advocates, family members, policy makers, providers and researchers in the field of addiction stigma will greatly benefit from reading this book.
This book explores the stigma of addiction and discusses ways to improve negative attitudes for better health outcomes. Written by experts in the field of addiction, the text takes a reader-friendly approach to the essentials of addiction stigma across settings and demographics. The authors reveal the challenges patients face in the spaces that should be the safest, including the home, the workplace, the justice system, and even the clinical community. The text aims to deliver tools to professionals who work with individuals with substance use disorders and lay persons seeking to combat stigma and promote recovery. The Stigma of Addiction is an excellent resource for psychiatrists, addiction medicine specialists, students across specialties, researchers, public health officials, and individuals with substance use disorders and their families.
This practice-enhancing volume assembles the latest innovative thinking on working with clients who have both mental health diagnoses and substance use disorders. Diagnosis is a central focus of the coverage, untangling the often-knotty considerations surrounding dual diagnosis and the complex issues surrounding treatment even in frequently seen combinations (e.g., depression/alcohol abuse). The section on practice emphasizes meeting patients where they are and making use of their community, cultural, and spiritual contexts in crafting interventions. And the book’s ambitious chapters on professional development describe training programs with the potential to produce the next generation of responsive, knowledgeable, and flexible therapists. Among the topics covered: · Comprehensive assessment of substance abuse and addiction risk in adolescents. · The relationship between attachment and addiction. · Addiction in the community: the role of emergency services. · Substance use during and after major crisis and disaster: a practitioner’s guide. · Practice, advocacy, and outreach: perspectives on addiction services. · Teaching the importance of developing the therapeutic relationship. New Directions in Treatment, Education, and Outreach for Mental Health and Addiction equips health and clinical psychologists, social workers, and addiction counselors and educators with a well-rounded understanding of a growing population, and a wealth of perspectives on effective new interventions.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
“This is a story she needed to tell; and the rest of the country needs to listen.” — New York Times Book Review “This vital memoir will change how we look at the opioid crisis and how the media talks about it. A deeply moving and emotional read, STRUNG OUT challenges our preconceived ideas of what addiction looks like.” —Stephanie Land, New York Times bestselling author of Maid In this deeply personal and illuminating memoir about her fifteen-year struggle with heroin, Khar sheds profound light on the opioid crisis and gives a voice to the over two million people in America currently battling with this addiction. Growing up in LA, Erin Khar hid behind a picture-perfect childhood filled with excellent grades, a popular group of friends and horseback riding. After first experimenting with her grandmother’s expired painkillers, Khar started using heroin when she was thirteen. The drug allowed her to escape from pressures to be perfect and suppress all the heavy feelings she couldn’t understand. This fiercely honest memoir explores how heroin shaped every aspect of her life for the next fifteen years and details the various lies she told herself, and others, about her drug use. With enormous heart and wisdom, she shows how the shame and stigma surrounding addiction, which fuels denial and deceit, is so often what keeps addicts from getting help. There is no one path to recovery, and for Khar, it was in motherhood that she found the inner strength and self-forgiveness to quit heroin and fight for her life. Strung Out is a life-affirming story of resilience while also a gripping investigation into the psychology of addiction and why people turn to opioids in the first place.
The two main sections of the book comprise chapters on 10 specific illnesses and conditions and chapters relating to broader issues (stigma and family, overcoming stigma, stigma across cultures and future directions). The book concludes with observations on what has not worked in overcoming stigma as well as possible future directions. (Psychology)
