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

Opioid-dependent patients have unique pain management and psychosocial needs. Inadequate staff training, the absence of addiction screening and intervention protocols, and stigma related to opioid use can impact outcomes negatively for these patients in general hospital settings.
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PMID:Managing pain in opioid-dependent patients in general hospital settings. 2346 97

Substance abuse counselors are vulnerable to burnout, which has negative repercussions for the counselor, employing organization, and clients. However, little is known about differences in counselor burnout from the counselors' perspective in rural versus urban treatment centers. In 2008, focus group data from 28 rural and urban counselors in a southern state were analyzed, revealing three burnout themes across all counselors: causes, consequences, and prevention. However, there were various differences between rural and urban counselors in subthemes, with only rural counselors citing office politics and low occupational prestige as causes of burnout. Only urban counselors reported responses endorsing the subthemes of role reversal, clients trying to choose their counselors, and changing jobs as consequences of burnout. All counselors cited coworker support, clinical supervision, and self-care as important strategies for managing burnout. In sum, context clearly matters as rural counselors cited more causes of burnout; yet, the implications of burnout are universal in that they often lead to poor quality clinical care. There is a continued need for greater understanding of addiction as a disease, which would reduce stigma, especially in rural areas, as well as increase the prestige and earning potential of the substance abuse counseling occupation.
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PMID:Causes, consequences, and prevention of burnout among substance abuse treatment counselors: a rural versus urban comparison. 2366 28

Restoring people with mental illnesses to community life after detention in jail is fraught with significant challenges. Many of these challenges mirror those faced by anyone else who has been detained in jail. Among these are the particular challenge of seeking gainful employment and financial support for day-to-day life. This challenge is intensified when individuals return from jail to impoverished communities where employment prospects are already limited for residents, and where either a criminal record or a mental illness creates still additional barriers to work. To understand these barriers more fully, this study examined the process of seeking employment among people with mental illnesses leaving jail. Seventeen individuals with a history of mental health problems and with recent jail incarcerations were recruited from either a community based employment program or a mental health service setting. The informants were interviewed using life history interview techniques. Results show that connections to the paid workforce were tenuous at best for these respondents, both before and after their jail detention. While psychiatric symptoms, addiction, and the lack of productive social connections were individual-level factors that affected employment, the most pernicious impediments were rooted in policy, community structures, stigma and other social and economic realities.. If employment interventions are to have any traction at all in these settings, interventionists need to dig for innovative ways to address these factors, which are not complications, but bedrock realities that undergird all else.
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PMID:"I'm not sure that I can figure out how to do that": Pursuit of work among people with mental illnesses leaving jail. 2393 55

What is the role and value of pleasure in addiction? Foddy and Savulescu (1) have claimed that substance use is just pleasure-oriented behavior. They describe addiction as "strong appetites toward pleasure" and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts (as philosophers rather than health professionals or peers) reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction.
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PMID:Pleasure and addiction. 2409 20

Approximately 30% of patients participating in the national antiretroviral therapy (ART) program in Argentina fail to achieve an undetectable viral load, and approximately 25% are not retained in care. This qualitative study was designed to explore and identify factors associated with engagement and retention in public and private health care in Buenos Aires, Argentina. Qualitative data from key informants (n = 12) and focus groups (n = 4 groups) of patients and providers from private and public HIV treatment facilities were recorded and transcribed. Predetermined and arising themes related to adherence, engagement, and retention in care were coded and analyzed using qualitative data analysis software. Reasons identified for patients' lack of adherence or engagement in care differed between patients and providers, and patients attributed limitations to low self-efficacy, fear and concerns about HIV, and lack of provider involvement in treatment. In contrast, providers viewed themselves as decision-makers in patient care and patients as responsible for their own nonadherence due to lack of commitment to their own health or due to medication side effects. Patients reported health care system limitations and HIV concerns contributed to a lack of engagement, and providers identified limited HIV literacy and stigma as additional problems. Both agreed that chronic illness and substance addiction impacted adherence and retention, and agreed on the importance of trust, honesty, and communication in the patient-provider relationship. Results support the incorporation of system-, provider-, and patient-focused components into interventions to facilitate patient engagement, adherence, and retention in public and private settings in Argentina.
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PMID:Patient-provider perceptions on engagement in HIV care in Argentina. 2413 88

Historical, cultural and professional factors have contributed to stigma and secrecy regarding addiction in the medical profession and there are calls to improve education in this area. This paper argues that physician-penned literature plays an important role in raising awareness of substance misuse in the medical profession. Bulgakov's short story Morphine documents the decline of Dr Polyakov and illustrates a number of salient professional issues such as self-medication, abuse of authority and risks to patients. Physician-penned literature such as Morphine is of value in medical education as it offers a route into sensitive topics and an authoritative and insider perspective that is attractive to students and physicians alike.
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PMID:Dr Junkie. The Doctor Addict in Bulgakov's Morphine: What are the Lessons for Contemporary Medical Practice? 2422 60

Public knowledge and attitudes about addiction are largely inconsistent with scientific evidence. The gap between the facts and public and professional perceptions is due in part to the language used to describe the disease and those who have it. A key step in modifying public attitudes and improving how health professionals and policymakers address addiction is to better align the language of addiction with the scientific evidence. Unless we clarify the language, those with the disease will continue to experience the stigma associated with it and attempts to deliver comprehensive and effective evidence-based prevention, treatment, and disease management will be profoundly compromised.
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PMID:Effectively addressing addiction requires changing the language of addiction. 2422 52

Stigma can be harmful to drug users, particularly those in need of treatment. Beliefs and opinions about drug use may influence how individuals view or treat drug users, so research was needed to examine whether specific beliefs and opinions are related to stigma towards users. A sample of 531 adults was assessed to examine how stigmatization relates to specific beliefs and opinions about drug use. Eighty percent of the sample reported lifetime use of an illicit drug. While controlling for demographic characteristics, lifetime drug use and exposure to users, stigmatization towards users more than doubled the odds of reporting that addiction is a choice, and more than tripled the odds for reporting that marijuana and heroin are equally dangerous. Stigmatization, however, lowered the odds of reporting that drugs would be okay to use if legal. Individuals who stigmatize drug users may be under-educated about drug use; however, such individuals appear to be at low risk for use. Beliefs and opinions guided by misinformation may negatively affect users, so public health efforts are needed to educate individuals about drug use and addiction in an objective manner, and treat use as more of a health behavior and less of a moral behavior.
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PMID:An examination of beliefs and opinions about drug use in relation to personal stigmatization towards drug users. 2459 61

Stigma continues to be the largest barrier for accessing treatment among people experiencing drug addiction. The dominant portrayals that exist about people who use drugs are often damaging and act to dehumanize the group as a whole. When left unchallenged, stereotypes can act as truthful depictions and facilitate the resistance against harm reduction services that are based on a human rights model. The use of labels is one way stigma is perpetuated by eliciting the label's stereotyped narratives onto an individual or group. Within harm reduction discourse, the word "addict" can have detrimental effects on how the public perceives people experiencing addiction and their deservingness of pragmatic services. This article aims to draw attention to the inattention we give "addict" in language and explain how its routine use in society acts to perpetuate addiction stigma. Using the example of supervised injection site opposition in Canada, the use of "addict" is used as a way to understand how stigma through language works to impede the expansion of harm reduction initiatives.
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PMID:Stigmatizing harm reduction through language: a case study into the use of "addict" and opposition to supervised injection sites in Canada. 2462 88

Addiction is widely recognized as a health problem with increasing prevalence. Treatment programs are growing in number, but many forms of addiction remain high and some lack treatment regimens. The total costs to society for addiction treatment programs and associated complications are staggering and continue to rise. This illuminates how frequently individuals affected by addiction encounter the healthcare system. Stigmatization or social disqualification of individuals affected by addiction is an increasing phenomenon in the healthcare arena. The negative consequences experienced by persons affected by stigmatization may include limited access to health care, poor health outcomes, prejudice, and other social disadvantages. The focus of this article is to examine addiction and stigma as obstacles to accessing and obtaining quality health care. It introduces the phenomenon addiction-stigmatized. This concept was developed to increase nurses' awareness and knowledge of the negative effect stigma has on the health of individuals with addiction.
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PMID:Addiction-stigmatized: a new concept to enhance nursing practice. 2462 94


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