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Healthcare provider stigma toward patients with substance use disorders.

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Title: Healthcare provider stigma toward patients with substance use disorders.
Authors: Parish, Carrigan L., Feaster, Daniel J., Pollack, Harold A., Horigian, Viviana E., Wang, Xiaoming, Jacobs, Petra, Pereyra, Margaret R., Drymon, Christina, Allen, Elizabeth, Gooden, Lauren K., del Rio, Carlos, Metsch, Lisa R.
Source: Addiction. Oct2025, Vol. 120 Issue 10, p2005-2019. 15p.
Subjects: Substance abuse, Cocaine, Repeated measures design, Medical personnel, Research funding, Methamphetamine, Data analysis, Probability theory, Questionnaires, Statistical sampling, Planned behavior theory, Medical care, Descriptive statistics, Dentists, Heroin, Attitudes of medical personnel, Opioid analgesics, Statistics, Type 2 diabetes, Alcoholism, Data analysis software, Confidence intervals, Psychosocial factors, Social stigma, Drug abusers, Fentanyl, Social distancing
Geographic Terms: United States
Abstract: Background and aims: The overdose epidemic accounts for more than 89 000 deaths across the United States annually. Despite the availability of medications and therapies to treat substance use disorders (SUD), most people remain untreated. Stigma towards treating patients with SUD has been identified as a potential barrier to SUD treatment. This study aimed to quantify the prevalence and intensity of provider stigma towards patients with SUD, by substance use type and compared with other conditions, and its relationship to providers' clinical practices. Design: National probability sample survey (October 2020–October 2022). Setting: USA; online/paper questionnaire. Participants: Primary care (PCPs) and emergency medicine physicians (EMPs) and dentists randomly selected from the American Medical and Dental Associations. Data were collected from 1240 participants (Council of American Survey Research Organizations response rate 53.6%). Measurements The main outcome was self‐reported provider stigma towards people with SUD, assessed by the Medical Condition Regard Scale. Providers indicated their agreement with 11 statements concerning three SUD categories [opioids (OUD), stimulants, alcohol (AUD)], Type II diabetes, depressive disorder and HIV. Mixed models compared stigma levels across conditions and by clinician group. Clinicians were assessed about their screening, referral and treatment practices. Findings The lowest stigma rating was for diabetes (mean = 23.2; standard deviation = 6.5) and the highest for stimulant use disorders (mean = 36.3; standard deviation = 10.7). Stigma towards OUD was statistically significantly higher than AUD [effect size (ES) = 0.49, 95% confidence interval (CI) = (0.42–0.57), P < 0.001], while stigma towards stimulant use disorders was statistically significantly higher than OUD [ES = 0.11, 95% CI = (−0.04 to 0.19), P < 0.004]. EMPs had statistically significantly higher stigma scores than PCPs (P < 0.001), while PCPs reported significantly higher stigma scores than did dentists (P < 0.014). Lower stigma scores were associated with provision of SUD referrals [ES = −0.37, 95% CI = (−0.66 to −0.07)], providing medications for OUD [stigma scores: AUD (ES = ‐0.44, 95% CI = [−0.73 to −0.15]), OUD (ES = −1.26, 95% CI = [−1.55 to −0.97]) and stimulant use disorder (ES = −0.73, 95% CI = [−1.02 to −0.44])] and having available SUD consultation [stigma scores: AUD (ES = −0.48, 95% CI = [−0.67 to −0.28]), OUD (ES = −0.51, 95% CI = [−0.86 to −0.37]) and stimulant use disorder (ES = −0.59, 95% CI = [−0.78 to −0.39])]. Conclusions: Among US primary care and emergency medicine physician workforces, provider stigma towards substance use disorders appears to be higher than for opioid, stimulant and alcohol use disorders and negatively associated with providers' clinical practices. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background and aims: The overdose epidemic accounts for more than 89 000 deaths across the United States annually. Despite the availability of medications and therapies to treat substance use disorders (SUD), most people remain untreated. Stigma towards treating patients with SUD has been identified as a potential barrier to SUD treatment. This study aimed to quantify the prevalence and intensity of provider stigma towards patients with SUD, by substance use type and compared with other conditions, and its relationship to providers' clinical practices. Design: National probability sample survey (October 2020–October 2022). Setting: USA; online/paper questionnaire. Participants: Primary care (PCPs) and emergency medicine physicians (EMPs) and dentists randomly selected from the American Medical and Dental Associations. Data were collected from 1240 participants (Council of American Survey Research Organizations response rate 53.6%). Measurements The main outcome was self‐reported provider stigma towards people with SUD, assessed by the Medical Condition Regard Scale. Providers indicated their agreement with 11 statements concerning three SUD categories [opioids (OUD), stimulants, alcohol (AUD)], Type II diabetes, depressive disorder and HIV. Mixed models compared stigma levels across conditions and by clinician group. Clinicians were assessed about their screening, referral and treatment practices. Findings The lowest stigma rating was for diabetes (mean = 23.2; standard deviation = 6.5) and the highest for stimulant use disorders (mean = 36.3; standard deviation = 10.7). Stigma towards OUD was statistically significantly higher than AUD [effect size (ES) = 0.49, 95% confidence interval (CI) = (0.42–0.57), P < 0.001], while stigma towards stimulant use disorders was statistically significantly higher than OUD [ES = 0.11, 95% CI = (−0.04 to 0.19), P < 0.004]. EMPs had statistically significantly higher stigma scores than PCPs (P < 0.001), while PCPs reported significantly higher stigma scores than did dentists (P < 0.014). Lower stigma scores were associated with provision of SUD referrals [ES = −0.37, 95% CI = (−0.66 to −0.07)], providing medications for OUD [stigma scores: AUD (ES = ‐0.44, 95% CI = [−0.73 to −0.15]), OUD (ES = −1.26, 95% CI = [−1.55 to −0.97]) and stimulant use disorder (ES = −0.73, 95% CI = [−1.02 to −0.44])] and having available SUD consultation [stigma scores: AUD (ES = −0.48, 95% CI = [−0.67 to −0.28]), OUD (ES = −0.51, 95% CI = [−0.86 to −0.37]) and stimulant use disorder (ES = −0.59, 95% CI = [−0.78 to −0.39])]. Conclusions: Among US primary care and emergency medicine physician workforces, provider stigma towards substance use disorders appears to be higher than for opioid, stimulant and alcohol use disorders and negatively associated with providers' clinical practices. [ABSTRACT FROM AUTHOR]
ISSN:09652140
DOI:10.1111/add.70122