Understanding stigma through the lived experiences of people with opioid use disorder

Stigma toward substance use disorders reduces treatment seeking and recovery efforts of persons who could most benefit from services. This is particularly true for opioid use disorder (OUD) stigma, which in recent years has likely fueled the overdose epidemic. Understanding the stigma surrounding OUD and stigma reduction efforts that can be implemented are needed to enhance treatment and recovery efforts. This project explores the lived experiences of persons who were in recovery from OUD or a family member of someone with OUD with a focus on stigma. We utilized a qualitative method to examine secondary data of published transcripts where people’s (N = 30) experiences with stigma emerged through storytelling. Thematic analysis found three overarching types of stigma that were described by participants, 1) Social stigma: misconceptions contributing to social stigma, labeling and associative stereotypes, persistence of stigma throughout recovery; 2) Self-stigma: internalized feelings due to stigma, concealing and continuing substance use, inadequacies of navigating recovery; and 3) Structural stigma: treatment and recovery resource barriers, challenges of reintegration. The experiences described by participants highlight the multifaceted impact of stigma on the individual as well as society and add to our understanding of the lived experience of stigma. Future recommendations are discussed to improve the experience of individuals with lived experience of OUD; including implementing evidence-based strategies to reduce stigma such as using stigma-free or person first language, dispelling common myths, and supporting comprehensive recovery pathways. •Multiple layers of stigma are experienced by those impacted by opioid use disorder.•Storytelling is an effective method to explore stigma and its constructs.•OUD stigma is experienced at the individual, social, and societal levels.•OUD stigma embodies similar constructs as mental health stigma with severe costs.•Reducing OUD stigma is key for enhancing treatment and recovery efforts.