The impact of stigma on treatment services for people with substance use disorders during the COVID-19 pandemic—perspectives of NECPAM members

Abstract

Stigma is a mark of shame, disgrace, or disapproval which results in an individual being rejected, discriminated against, and excluded fromsociety (1). Stigma toward individuals with substance use disorders (SUDs) affects the emotional, mental, and physical health of individuals (2). People with SUD are often viewed as unpredictable, dangerous, and morally responsible for their condition (2). These prejudiced and discriminatory views of the community may lead to reduced access to care, inability to make decisions regarding treatment, and forced or coerced treatment (2). Further, stigma negatively affects the policies and programs intended for the management of substance use and other addictive disorders (2). Moreover, people with addictive disorders may develop selfstigma influencing their behavior, including decreased use of healthcare services with consequent poorer health outcomes (3). Internalized stigma and self-stigma have been linked to increases in psychological distress and poorer quality of life (4, 5). People with substance use disorders (SUDs), in particular, may face significant stigmatization by healthcare practitioners (6). Of significant concern during the COVID-19 pandemic is that people with addictive disorders and concurrent COVID-19 may not be provided with adequate care (7). Therefore, people with SUDs may be experiencing increased stigmatization in different countries during the COVID-19 pandemic. This exacerbated stigma and discrimination toward people with SUDs may lead to inadequate care or poor attention from clinicians, policymakers, and other stakeholders.