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Access Type
WSU Access
Date of Award
January 2023
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Social Work
First Advisor
Stella M. Resko
Abstract
Harm reduction interventions such as overdose reversal medication distribution, safe consumption sites, and low-barrier treatment with agonist medications are shown to be highly effective strategies to reduce the negative consequences of nonmedical opioid use and opioid use disorder (OUD). However, stigma constitutes a substantial barrier to harm reduction service implementation. While a growing body of research documents the harms of “condition stigma” toward OUD, less is known about “intervention stigma” (Madden, 2019) directed toward harm reduction modalities. This three-article dissertation examines stigma toward harm reduction interventions for OUD and its impact on service provision. Specifically, Chapter Two examines the association between perceived stigma toward naloxone and naloxone training outcomes among naloxone training attendees. Chapters Three and Four focus on the attitudes of peer recovery coaches (PRCs) in OUD services, many of whom have lived experience in abstinence-based treatment and recovery programs; Chapter Three identifies factors influencing PRCs’ support for safe consumption sites, and Chapter Four explores how PRCs’ attitudes toward medications for OUD affect their interactions with clients.Results provide insight into the impact of stigma on harm reduction service implementation and highlight specific areas for intervention. Stigma toward harm reduction affected naloxone training outcomes, PRCs’ support for services, and PRCs’ interactions with clients taking or considering MOUD. Abstinence ideology, stigma toward people who use drugs, and lack of knowledge of or exposure to harm reduction philosophy emerged as primary drivers of stigma toward harm reduction. However, stigma appeared to operate differently across racial-ethnic groups and among people with lived experience. Further, attitudes toward harm reduction were contextual, or dependent on when, how, and by whom services were used. Increased efforts are needed to reduce stigma toward harm reduction interventions for OUD, particularly among people of color and PRCs in abstinence-based recovery. Stigma reduction will be fundamental to successful expansion of evidence-based health services for people with OUD.
Recommended Citation
Pasman, Emily, "Stigma Toward Harm Reduction Interventions For Opioid Use Disorder" (2023). Wayne State University Dissertations. 3841.
https://digitalcommons.wayne.edu/oa_dissertations/3841