The stigmatization of problem drug users: A narrative literature review

Background: A stigma is a long-lasting mark of social disgrace that has a profound effect on interactions between the stigmatized and the unstigmatized. Factors governing the extent of stigmatization attached to an individual include the perceived danger posed by that person and the extent to which she/he is seen as being to blame for the stigma. Methods: Systematic database searches identified 185 papers for inclusion in the review, all of which were read and findings analysed and compared. Results: Stigmatizing attitudes towards problem drug users (PDUs) are common among the general public and non-specialist professionals. The impact on users is profound and represents a significant barrier to recovery. Reasons for this extreme stigmatization include negative reactions to injecting and widespread attributions concerning danger and blame. Advocacy and practice responses include challenging media language and stereotypes, encouraging public figures to speak out about their personal experiences, improved training for non-specialist staff and greater contact between PDUs and the public. Conclusion: Stigmatization has a profound effect on PDUs' lives and their chances of recovery. Efforts need to be made to diminish inflated fears about users and help people to understand that PDUs are not simply and solely 'to blame' for their condition.