Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support
•Assessed internalized stigma and substance use problems among primary care patients.•Internalized stigma rates similar to extant literature from specialty care samples.•Higher internalized stigma was significantly related to more substance use problems.•Internalized stigma significantly added to un...
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| Veröffentlicht in: | Drug and alcohol dependence 2017-11, Vol.180, p.52-55 |
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| creator | Kulesza, Magdalena Watkins, Katherine E. Ober, Allison J. Osilla, Karen C. Ewing, Brett |
| description | •Assessed internalized stigma and substance use problems among primary care patients.•Internalized stigma rates similar to extant literature from specialty care samples.•Higher internalized stigma was significantly related to more substance use problems.•Internalized stigma significantly added to understanding of substance use problems.
Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs).
We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs. Regression analyses examined the relationship between internalized stigma and substance use problems, controlling for demographics, psychiatric comorbidity, and quantity/frequency of use.
The majority of participants reported thinking, at least sometimes, that they “have permanently screwed up” their lives (60%), and felt “ashamed” (60%), and “out of place in the world” (51%) as a result of their opioid or alcohol use. Higher internalized stigma was significantly related to more substance use problems (β=2.68, p |
| doi_str_mv | 10.1016/j.drugalcdep.2017.08.002 |
| format | Article |
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Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs).
We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs. Regression analyses examined the relationship between internalized stigma and substance use problems, controlling for demographics, psychiatric comorbidity, and quantity/frequency of use.
The majority of participants reported thinking, at least sometimes, that they “have permanently screwed up” their lives (60%), and felt “ashamed” (60%), and “out of place in the world” (51%) as a result of their opioid or alcohol use. Higher internalized stigma was significantly related to more substance use problems (β=2.68, p<0.01), even after the effects of covariates were accounted for. Stigma added 22%, out of 51% total variance explained, leading to a significant improvement in prediction of substance use problems.
Among this group of primary care patients with OAUDs, rates of internalized stigma were comparable to those reported in specialty substance use treatment settings. Consistent with extant specialty care literature, our results suggest that internalized stigma may be a unique contributor that is associated with treatment outcomes, such as substance use problems, among primary care patients with OAUDs.</description><identifier>ISSN: 0376-8716</identifier><identifier>EISSN: 1879-0046</identifier><identifier>DOI: 10.1016/j.drugalcdep.2017.08.002</identifier><identifier>PMID: 28869858</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Alcohol ; Alcohol related disorders ; Alcohol use ; Alcoholism ; Alcoholism - psychology ; Alcohols ; Clinical outcomes ; Comorbidity ; Demographics ; Demography ; Drug use ; Health care ; Humans ; Independent variables ; Integrated care ; Internalization ; Internalized stigma ; Medical treatment ; Opioids ; Patients ; Primary care ; Primary care treatment ; Primary Health Care ; Regression analysis ; Risk Factors ; Severity ; Social Stigma ; Stigma ; Substance use ; Substance use disorder ; Substance use problems ; Substance-Related Disorders - psychology ; Treatment methods</subject><ispartof>Drug and alcohol dependence, 2017-11, Vol.180, p.52-55</ispartof><rights>2017 Elsevier B.V.</rights><rights>Copyright © 2017 Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Nov 1, 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-661ef450752a6cfef9165da65b87026b9a39189e5320290d46988c68719c56cd3</citedby><cites>FETCH-LOGICAL-c507t-661ef450752a6cfef9165da65b87026b9a39189e5320290d46988c68719c56cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.drugalcdep.2017.08.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,777,781,882,3537,27905,27906,30980,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28869858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kulesza, Magdalena</creatorcontrib><creatorcontrib>Watkins, Katherine E.</creatorcontrib><creatorcontrib>Ober, Allison J.</creatorcontrib><creatorcontrib>Osilla, Karen C.</creatorcontrib><creatorcontrib>Ewing, Brett</creatorcontrib><title>Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support</title><title>Drug and alcohol dependence</title><addtitle>Drug Alcohol Depend</addtitle><description>•Assessed internalized stigma and substance use problems among primary care patients.•Internalized stigma rates similar to extant literature from specialty care samples.•Higher internalized stigma was significantly related to more substance use problems.•Internalized stigma significantly added to understanding of substance use problems.
Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs).
We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs. Regression analyses examined the relationship between internalized stigma and substance use problems, controlling for demographics, psychiatric comorbidity, and quantity/frequency of use.
The majority of participants reported thinking, at least sometimes, that they “have permanently screwed up” their lives (60%), and felt “ashamed” (60%), and “out of place in the world” (51%) as a result of their opioid or alcohol use. Higher internalized stigma was significantly related to more substance use problems (β=2.68, p<0.01), even after the effects of covariates were accounted for. Stigma added 22%, out of 51% total variance explained, leading to a significant improvement in prediction of substance use problems.
Among this group of primary care patients with OAUDs, rates of internalized stigma were comparable to those reported in specialty substance use treatment settings. Consistent with extant specialty care literature, our results suggest that internalized stigma may be a unique contributor that is associated with treatment outcomes, such as substance use problems, among primary care patients with OAUDs.</description><subject>Alcohol</subject><subject>Alcohol related disorders</subject><subject>Alcohol use</subject><subject>Alcoholism</subject><subject>Alcoholism - psychology</subject><subject>Alcohols</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Demographics</subject><subject>Demography</subject><subject>Drug use</subject><subject>Health care</subject><subject>Humans</subject><subject>Independent variables</subject><subject>Integrated care</subject><subject>Internalization</subject><subject>Internalized stigma</subject><subject>Medical treatment</subject><subject>Opioids</subject><subject>Patients</subject><subject>Primary care</subject><subject>Primary care treatment</subject><subject>Primary Health Care</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Severity</subject><subject>Social Stigma</subject><subject>Stigma</subject><subject>Substance use</subject><subject>Substance use disorder</subject><subject>Substance use problems</subject><subject>Substance-Related Disorders - psychology</subject><subject>Treatment methods</subject><issn>0376-8716</issn><issn>1879-0046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFUV2L1TAQDaK419W_IAGfW5N-pIkPgi5-LCwIos8hTabXXNumJumC_oX90zvlXlf3aQNJJsyZM5NzCKGclZxx8fpQurjuzWgdLGXFeFcyWTJWPSI7LjtVMNaIx2TH6k4UsuPijDxL6cBwCcWekrNKSqFkK3fk5nLOEGcz-j_gaMp-PxlqEjUz9TOyAx5zptGnn3QwNodIB9xp7VM2swW6JqBLDP0IE1ZNYd7j008m_qbWRMyZ7JEhvaFfMQrYCZDcIQhGP_l5A6Z1WULMz8mTwYwJXpzuc_L944dvF5-Lqy-fLi_eXRW2ZV0uhOAwNBi2lRF2gEFx0Toj2l52rBK9MrXiUkFbV6xSzDX4VWkF6qBsK6yrz8nbI--y9hM4i-NFM-rT2DoYr-9nZv9D78O1bkUjRV0hwasTQQy_VkhZH8K6iZg0Vx1TjWTNhpJHlI0hpQjDXQfO9GajPuh_NurNRs2kRhux9OX_E94V_vUNAe-PAECdrj1EnSzKbMH5CDZrF_zDXW4BrAy3lw</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Kulesza, Magdalena</creator><creator>Watkins, Katherine E.</creator><creator>Ober, Allison J.</creator><creator>Osilla, Karen C.</creator><creator>Ewing, Brett</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope></search><sort><creationdate>20171101</creationdate><title>Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support</title><author>Kulesza, Magdalena ; Watkins, Katherine E. ; Ober, Allison J. ; Osilla, Karen C. ; Ewing, Brett</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-661ef450752a6cfef9165da65b87026b9a39189e5320290d46988c68719c56cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Alcohol</topic><topic>Alcohol related disorders</topic><topic>Alcohol use</topic><topic>Alcoholism</topic><topic>Alcoholism - psychology</topic><topic>Alcohols</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Demographics</topic><topic>Demography</topic><topic>Drug use</topic><topic>Health care</topic><topic>Humans</topic><topic>Independent variables</topic><topic>Integrated care</topic><topic>Internalization</topic><topic>Internalized stigma</topic><topic>Medical treatment</topic><topic>Opioids</topic><topic>Patients</topic><topic>Primary care</topic><topic>Primary care treatment</topic><topic>Primary Health Care</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Severity</topic><topic>Social Stigma</topic><topic>Stigma</topic><topic>Substance use</topic><topic>Substance use disorder</topic><topic>Substance use problems</topic><topic>Substance-Related Disorders - psychology</topic><topic>Treatment methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kulesza, Magdalena</creatorcontrib><creatorcontrib>Watkins, Katherine E.</creatorcontrib><creatorcontrib>Ober, Allison J.</creatorcontrib><creatorcontrib>Osilla, Karen C.</creatorcontrib><creatorcontrib>Ewing, Brett</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Drug and alcohol dependence</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kulesza, Magdalena</au><au>Watkins, Katherine E.</au><au>Ober, Allison J.</au><au>Osilla, Karen C.</au><au>Ewing, Brett</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support</atitle><jtitle>Drug and alcohol dependence</jtitle><addtitle>Drug Alcohol Depend</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>180</volume><spage>52</spage><epage>55</epage><pages>52-55</pages><issn>0376-8716</issn><eissn>1879-0046</eissn><abstract>•Assessed internalized stigma and substance use problems among primary care patients.•Internalized stigma rates similar to extant literature from specialty care samples.•Higher internalized stigma was significantly related to more substance use problems.•Internalized stigma significantly added to understanding of substance use problems.
Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs).
We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs. Regression analyses examined the relationship between internalized stigma and substance use problems, controlling for demographics, psychiatric comorbidity, and quantity/frequency of use.
The majority of participants reported thinking, at least sometimes, that they “have permanently screwed up” their lives (60%), and felt “ashamed” (60%), and “out of place in the world” (51%) as a result of their opioid or alcohol use. Higher internalized stigma was significantly related to more substance use problems (β=2.68, p<0.01), even after the effects of covariates were accounted for. Stigma added 22%, out of 51% total variance explained, leading to a significant improvement in prediction of substance use problems.
Among this group of primary care patients with OAUDs, rates of internalized stigma were comparable to those reported in specialty substance use treatment settings. Consistent with extant specialty care literature, our results suggest that internalized stigma may be a unique contributor that is associated with treatment outcomes, such as substance use problems, among primary care patients with OAUDs.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>28869858</pmid><doi>10.1016/j.drugalcdep.2017.08.002</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Drug and alcohol dependence, 2017-11, Vol.180, p.52-55 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Alcohol Alcohol related disorders Alcohol use Alcoholism Alcoholism - psychology Alcohols Clinical outcomes Comorbidity Demographics Demography Drug use Health care Humans Independent variables Integrated care Internalization Internalized stigma Medical treatment Opioids Patients Primary care Primary care treatment Primary Health Care Regression analysis Risk Factors Severity Social Stigma Stigma Substance use Substance use disorder Substance use problems Substance-Related Disorders - psychology Treatment methods |
| title | Internalized stigma as an independent risk factor for substance use problems among primary care patients: Rationale and preliminary support |
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