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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The therapeutic community (TC) and methadone maintenance treatment (MMT) have individually demonstrated consistent positive outcomes yet rarely have been combined. This article describes how a well-established residential therapeutic community integrated methadone maintenance treatment into its activities. Practical recommendations regarding how to incorporate MMT in a residential program are provided including topics for staff (training, coordination with the methadone service provider agency), patients (education, confronting stigma about methadone maintenance), and potential therapeutic activities (methadone group therapy). The implementation of these staff, patient, and therapeutic adaptations can assist residential substance abuse treatment programs in integrating these two addiction treatment modalities.
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PMID:Methadone maintenance therapy in residential therapeutic community settings: challenges and promise. 1815 73

While research has clearly documented the difficulties injectors encounter in accessing specialist addiction services, there is less evidence of the problems they face when securing general health care and non-substance-misuse-specific support. This paper seeks to fill some of these knowledge gaps. Between January and May 2006, 75 current injectors were recruited and interviewed through three needle exchange programmes located in diverse geographical areas of West Yorkshire. Interview data were transcribed verbatim and analysed using Framework. Findings showed that injectors were often positive about the help they received from generic health and social care services. Nonetheless, they identified a range of barriers relating to inability to access desired assistance, the burden of appointments, travel to services, stigma and negative staff attitudes, personal ill-health, lack of material resources, and anxieties about accessing support. Although some types of barriers were more evident at some services than at others and/or affected particular subgroups of injector more than others, the impact of any barrier was contingent on a range of factors. These included the attitudes of individual professionals, the circumstances and needs of individual injectors, the local availability of suitable alternative services, and the frequency with which a service needed to be accessed. In order to better understand and potentially reduce service barriers, findings are linked to broader conceptual and theoretical debates relating to social exclusion and Foucault's analyses of power and knowledge.
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PMID:Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. 1829 Sep 80

The term "recovery" is often used in the addiction field. However, we have thus far failed to define the term, to delineate its dimensions, or to elucidate the prerequisite conditions to this outcome. This has hindered service development and evaluation as well as changes in policy. This paper: 1. Reviews empirical findings about how "recovery" is defined and experienced by individuals engaged in the process; 2. Examines factors associated with recovery initiation, maintenance, and sustained lifestyle, and review obstacles to recovery; and 3. Discusses implications for services and research; implications include the need to adopt a long-term, wellness-centered approach to addressing substance use related problems, the importance for society to address the stigma of former addiction and to offer attractive viable opportunities to promote making significant life changes toward recovery from substance use.
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PMID:The road to recovery: where are we going and how do we get there? Empirically driven conclusions and future directions for service development and research. 1901 76

The coming decades will see exciting breakthroughs in the treatment of SUDs, such as further elucidation of the genetic mechanisms of addiction. Yet if the past is any guide to the future, each new discovery will bring with it new challenges to the core ethical obligations of honoring informed consent, protecting confidentiality, and respecting justice, while also protecting the public from harm and ensuring the good of the individual patient. For the emerging scientific shift to a biobehavioral model of addiction to transform cultural attitudes and enhance treatment and research will require the scientifically rigorous and ethically sound agency of ethicists and addiction professionals to influence public policy. The growing body of neurobiologic evidence that contests traditional assumptions about free will and responsibility will evoke more deliberate and nuanced approaches to informed consent and treatment participation and dispute the forensic orientation in drug policy. If this unprecedented paradigm change can influence health care decision making in a reasoned and balanced fashion, there is real hope that the cultural stigma, which has warranted highly stringent confidentiality protections, and the disenfranchisement underlying health disparities in addiction treatment may move in the direction of compassionate and competent care for all those who suffer from addiction.
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PMID:Ethics in substance use disorder treatment. 1948 14

More than 2.4 million people are currently incarcerated in the United States, many as a result of drug-related offenses. In addition, more than 200,000 active heroin addicts pass through the correctional system annually. New evidence suggests that both providing prisoners with referrals for community-based methadone programs and providing methadone prior to release reduces recidivism and adverse health and social consequences associated with drug use. This article reports the programmatic challenges associated with initiating methadone treatment in the Rhode Island correctional system. Significant obstacles to implementing methadone treatment include: stigma associated with pharmacological treatment, misconceptions regarding the nature of opioid addiction, logistics of control and storage of methadone, increased work load for nursing staff and general safety and control concerns. The authors discuss strategies to address these barriers and conclude that providing methadone prior to inmate release is a feasible intervention with the potential to mitigate drug-related health and social harms.
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PMID:Overcoming obstacles to implementing methadone maintenance therapy for prisoners: implications for policy and practice. 1973 2

Social stigma continues to be a barrier for health promotion in our society. One of the most stigmatized health conditions in our time continues to be addiction to illicit drug use. Although it has been widely recognized as a health concern, criminalizing approaches continue to be common in Puerto Rico. Health professionals need to engage in challenging the stigma of illicit drug use in order to foster policies and government efforts with health-oriented approaches. Still, personal stigmatizing attitudes among them continue to be a barrier for the implementation of this agenda. Therefore, the main objectives of this study were to document stigma towards illicit drug use among a sample of health professionals in training, and explore differences in such attitudes among participants from different areas of training. In order to achieve this objective we carried out a sequential mixed method approach with a sample of 501 health professionals in training or practice from the disciplines of medicine, nursing, psychology and social work. Results evidence the continued existence of stigmatizing attitudes among this population. We discuss some of the implications for public health and potential strategies for action.
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PMID:Stigmatization of illicit drug use among Puerto Rican health professionals in training. 2049 25

This article provides an overview of central issues in chronic nonmalignant pain management with a focus on prescribing opioid analgesics. Definitions are provided for terminology regarding pain and addiction. Epidemiology of addiction among patients with chronic nonmalignant pain is reviewed. Benefits and complications of opioid therapy are discussed, along with recent regulatory issues for prescribers and use of medication agreements. Nonopioid treatments are reviewed. A standardized approach to chronic nonmalignant pain reduces stigma and improves patient care, therefore, an algorithm is presented for management of chronic nonmalignant pain.
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PMID:Addiction issues in prescribing opioids for chronic nonmalignant pain. 2176 25

Major well-defined medical problems that are, in part, the unfortunate outcome of a negative social environment may include specific addictive diseases and other mental health disorders, in particular the affective disorders of anxiety, depression, social phobia, and posttraumatic stress syndrome. This overview touches on the topic of extreme marginalization associated with addiction and other mental health disorders, along with arrest, imprisonment, and parole. All of these are characterized by a lasting stigma that hauntingly continues to affect each person suffering from any of these problems.
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PMID:Extreme marginalization: addiction and other mental health disorders, stigma, and imprisonment. 2188 62

Year after year, the public view nurses at the top of the list of the most honest and ethical professionals. However, nurses impaired with substance use disorders are subject to the tremendous stigma associated with addiction. Successful treatment programs protect public safety and support nurses' recovery and reentry into practice. The purpose of this study was to explore the nurses' experience in an alternative-to-discipline treatment program, the Indiana State Nurses Assistance Program (ISNAP), administered by the Indiana State Nurses Association. For this study, focus groups were used to capture nurses' experience with the ISNAP, a nurse-monitoring program for substance use. Three focus groups were conducted with 25 participants. The overall theme of the focus groups was enhancing mutual accountability. Nurses' views were grouped into four major areas of importance, including accountability, clear expectations, addressing individual concerns, and educating others about substance use disorders. Nurses described how each of these factors supported and impeded their recovery. The findings support the need for further education and research on how to best promote and sustain recovery.
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PMID:Enhancing mutual accountability to promote quality, safety, and nurses' recovery from substance use disorders. 2211 98

Striking increases in the abuse of opioids have expanded the need for pharmacotherapeutic interventions. The obstacles that confront effective treatment of opioid addiction - shortage of treatment professionals, stigma associated with treatment and the ability to maintain abstinence - have led to increased interest in alternative treatment strategies among both treatment providers and patients alike. Herbal products for opioid addiction and withdrawal, such as kratom and specific Chinese herbal medications such as WeiniCom, can complement existing treatments. Unfortunately, herbal treatments, while offering some advantages over existing evidence-based pharmacotherapies, have poorly described pharmacokinetics, a lack of supportive data derived from well controlled clinical trials, and severe toxicity, the cause for which remains poorly defined. Herbal products, therefore, require greater additional testing in rigorous clinical trials before they can expect widespread acceptance in the management of opioid addiction.
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PMID:Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy? 2213 23


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