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Cited by 198Substance Abuse Treatment and OutcomesMental Health Treatment and AccessOpioid Use Disorder Treatment

A systematic review of stigma interventions for providers who treat patients with substance use disorders

Bielenberg, Jennifer, Swisher, Gabrielle, Lembke, Anna, Haug, Nancy A.·2021·Journal of Substance Abuse Treatment
DOI 10.1016/j.jsat.2021.108486
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Abstract

Background Stigma surrounding substance use disorders (SUDs) is a frequently cited barrier to treatment engagement. Research consistently demonstrates that healthcare professionals' attitudes towards patients with addiction problems are often negative and may adversely impact service delivery. The current study presents a systematic review of stigma interventions for providers who treat patients with SUDs, in order to evaluate the quality of existing studies and potential for implementation in clinical settings.Methods This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases included PubMed, APA PsycInfo and the Cochrane Database of Systematic Reviews. Of the 1462 records identified between 2011 and 2019, 15 studies were eligible for inclusion. A narrative synthesis of stigma interventions summarized the change in stigmatizing attitudes held by providers.Results Studies included heterogeneous and culturally diverse samples of providers (N = 1324), who varied by age, location, discipline, and experience, with the exception of primarily female providers (75%). Results delineated six types of provider stigma interventions with components including online education, in-person education, in-person contact with consumers in recovery, or some combination of these elements. The highest quality studies incorporated motivational interviewing or communication training interventions, and many interventions combined either in-person mentorship or contact with individuals in recovery. Positive effects on provider attitudes occurred at several levels of educational and consumer contact interventions. Interventions with consumer contact demonstrated long-term maintenance of attitudinal shifts. Despite significant methodological limitations and low-quality assessment ratings, several studies utilized real-world providers and patients, as well as practical, innovative, brief, and potentially cost-effective interventions, particularly in locations with limited technological resources.Conclusions Research on provider stigma interventions increased in recent years, indicating greater worldwide attention to the negative impact of stigma. While educational interventions alone can be helpful in attitudinal change, contact with individuals in recovery from SUDs is a vital component of provider stigma interventions, particularly for lasting effects. This review highlights the importance of including implementation outcomes, such as sustainability and cost-effectiveness, in the study of stigma interventions for providers of addiction treatment.

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  • While there are manifold efforts aiming to reduce providers' and the public's stigmatizing attitudes, evidence on the effectiveness of stigma interventions specifically targeting people with HIV who inject drugs in order to facilitate care engagement is limited.

    “While there are manifold efforts aiming to reduce providers' and the public's stigmatizing attitudes,16,17 evidence on the effectiveness of stigma interventions specifically targeting people with HIV who inject drugs in order to facilitate care engagement is limited.1,18”

    From An acceptance-based, intersectional stigma coping intervention for people with HIV who inject drugs—a randomized clinical trial (2023) · cites this paper as [16]

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Authors
Bielenberg, J., Swisher, G., Lembke, A., & Haug, N. A.
Affiliations
  • Palo Alto University (US)
  • Stanford Medicine (US)
Corresponding author
  • Bielenberg, Jennifer
  • Swisher, Gabrielle
  • Lembke, Anna
  • Haug, Nancy A.
ORCID
Lembke, Anna
Venue
Journal of Substance Abuse Treatment
Publisher
Elsevier BV
Published
2021-12
Volume
131
Pages
108486
ISSN
0740-5472 (ISSN-L)
DOI
10.1016/j.jsat.2021.108486
OpenAlex
W3165836256
Cited by
198
References
94
Citations by year
2026: 41 · 2025: 58 · 2024: 60 · 2023: 30 · 2022: 9
FWCI
3.82
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Substance Abuse Treatment (publishedVersion)
  • PubMed (publishedVersion)
Funders
Stanford University
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
stigma reduction interventions, substance use disorders, clinician attitudes, addiction treatment, motivational interviewing, communication training, provider education, stigma reduction, implementation outcomes, cost-effectiveness
MeSH terms
Attitude of Health Personnel, Female, Humans, Substance-Related Disorders, Social Stigma

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