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Stigma and the Opioid Crisis: Summary

Purpose

Despite the prevalence of mental illness and substance use across Canada, people who live with such experiences are often still met with stigma. Mental health- and substance use-related stigma can have profound consequences on an individual, especially when it comes from health-care providers and first responders. Such stigma is a major barrier to accessing care, treatment, and recovery and has had a particularly negative impact on those affected by the opioid crisis.

Methodology

Stigma and the Opioid Crisis, a Mental Health Commission of Canada (MHCC) qualitative study, reveals a number of key findings on opioid-related stigma: its character (in the context of direct care and response),1 impacts, sources, and promising approaches available for tackling it.

Key Findings

What opioid-related stigma looks and feels like

  • Negative attitudes, judgments, and stereotypes
  • Problematic use of labels and language
  • Negative interactions between clients and care providers
  • Shame and the internalization of addiction
  • Punitive and exclusionary policies and practices

Where opioid-related stigma comes from

  • Punitive views about addiction, treatment, and recovery
  • The illegality of certain opioids and other drugs
  • People who use opioids being seen as unworthy and undeserving
  • Ambivalent stances on emergency relief
  • Trauma, compassion fatigue, and burnout
  • System inadequacies and gaps in services and policies

What impacts opioid-related stigma has

  • Affects how we conceptualize, frame, and prioritize the current crisis
  • Leads to the avoidance of services and creates barriers to help-seeking
  • Contributes to ongoing system mistrust, particularly among marginalized populations
  • Results in a poorer quality of care and response to clients

What promising approaches exist for tackling opioid-related stigma

  • Education on addiction, treatment, and recovery
  • Interventions focused on building client-provider trust
  • Social contact as a key stigma-reduction tool
  • Training in trauma-informed practice and care
  • Inward-facing training to build resilience and mitigate burnout among first responders and health-care providers (i.e., training that encourages participants to self-reflect)
  • Addressing system gaps and barriers

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