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Chapter 6 - Intersectional Stigma in Substance Use Disorders

Published online by Cambridge University Press:  23 June 2022

By
Daniel Dittrich  and
Georg Schomerus
Edited by
Georg Schomerus  and
Patrick William Corrigan
Georg Schomerus
Affiliation:
Universität Leipzig
Patrick William Corrigan
Affiliation:
Illinois Institute of Technology
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Summary

Substance use disorders (SUD) often occur in companion to other stigmatized characteristics, e.g., lower socioeconomic status, employment status, criminal record, race, gender, sexual orientation, or comorbid physical condition. Isolating each of these conditions when addressing stigma might miss the complexity of injustice and discrimination in our society. The concept of intersectional stigma addresses the effect of combined disadvantageous positions. This chapter provides an overview of findings on SUD stigma at intersectionality’s classical focal points: the intersections of race, gender, sexual orientation, and socioeconomic status. We then discuss the following questions: does intersectional analysis of SUD stigma need to include additional attributes to fully capture the multifaceted nature of SUD stigma, and how can they be identified? Are there common denominators of SUD stigma that can be addressed with broader benefit? Finally, we present how intersectional analysis can result in practical interventions that might help people with SUD become more resilient to stigmatization.

Keywords

intersectionalitysubstance use disorderintersectional stigmahealth inequities
Type
Chapter
Information
The Stigma of Substance Use Disorders , pp. 88 - 106
Publisher: Cambridge University Press
Print publication year: 2022

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References

Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry: The Journal of Mental Science, 203(2), 146–151.Google Scholar
Barry, C. L., McGinty, E. E., Pescosolido, B. A., & Goldman, H. H. (2014). Stigma, discrimination, treatment effectiveness, and policy: Public views about drug addiction and mental illness. Psychiatric Services, 65(10), 1269–1272.Google Scholar
Becker, J. B., McClellan, M., & Reed, B. G. (2016). Sociocultural context for sex differences in addiction. Addiction Biology, 21(5), 1052–1059.Google Scholar
Berger, M. T. (2006). Workable sisterhood: The political journey of stigmatized women with HIV/AIDS. Princeton University Press.Google Scholar
Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality – an important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273.Google Scholar
Burgard, S. A., Cochran, S. D., & Mays, V. M. (2005). Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women. Drug and Alcohol Dependence, 77(1), 61–70.Google Scholar
Canadian Observatory on Homelessness. (2017). Designing common spaces for women centred supportive housing: A practical application of intersectional feminist analysis. www.homelessnesslearninghub.ca/library/resources/designing-common-spaces-women-centred-supportive-housing-practical-applicationGoogle Scholar
Canadian Observatory on Homelessness. (2020). Intersectionality – power shuffle exercise. www.homelessnesslearninghub.ca/learning-materials/2slgbtqia-toolkit/intersectionality-power-shuffle-exerciseGoogle Scholar
Canadian Observatory on Homelessness. (2021). Intersectionality – homelessness learning hub. www.homelessnesslearninghub.ca/learning-materials/2slgbtqia-toolkit/2slgbtqia-youth-programming/intersectionalityGoogle Scholar
Carliner, H., Delker, E., Fink, D. S., Keyes, K. M., & Hasin, D. S. (2016). Racial discrimination, socioeconomic position, and illicit drug use among US Blacks. Social Psychiatry and Psychiatric Epidemiology, 51(4), 551–560.Google Scholar
Ciftci, A., Jones, N., & Corrigan, P. W. (2013). Mental health stigma in the Muslim community. Journal of Muslim Mental Health, 7(1).Google Scholar
Cochran, S. D., & Mays, V. M. (2000). Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. American Journal of Epidemiology, 151(5), 516–523.Google Scholar
Cochran, S. D., Mays, V. M., Alegria, M., Ortega, A. N., & Takeuchi, D. (2007). Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults. Journal of Consulting and Clinical Psychology, 75(5), 785–794.Google Scholar
Columbia Law School. (2017). Kimberlé Crenshaw on intersectionality, more than two decades later. www.law.columbia.edu/news/archive/kimberle-crenshaw-intersectionality-more-two-decades-laterGoogle Scholar
Corrigan, P. W. (2011). Best practices: Strategic stigma change (SSC): Five principles for social marketing campaigns to reduce stigma. Psychiatric Services, 62(8), 824–826.Google Scholar
Corrigan, P. W., & Wassel, A. (2008). Understanding and influencing the stigma of mental illness. Journal of Psychosocial Nursing and Mental Health Services, 46(1), 42–48.Google Scholar
Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. The University of Chicago Legal Forum, 1, 139–167.Google Scholar
DeGraffenreid v. General Motors Assembly Div., etc., 413 F. Supp. 142 (E.D. Mo. 1976). https://law.justia.com/cases/federal/district-courts/FSupp/413/142/1660699/Google Scholar
Dobson, M. (2013). Intersectionality: A fun guide. https://miriamdobson.com/2013/04/24/intersectionality-a-fun-guide/Google Scholar
Drabble, L., Midanik, L. T., & Trocki, K. (2005). Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: Results from the 2000 National Alcohol Survey. Journal of Studies on Alcohol, 66(1), 111–120.Google Scholar
Eylem, O., Wit, L. de, van Straten, A., et al. (2020). Stigma for common mental disorders in racial minorities and majorities: A systematic review and meta-analysis. BMC Public Health, 20(1), Article 879.Google Scholar
Farina, A. (1981). Are women nicer people than men? Sex and the stigma of mental disorders. Clinical Psychology Review, 1(2), 223–243.Google Scholar
Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2018). Associations between socioeconomic status and psychological therapy outcomes: A systematic review and meta-analysis. Depression and Anxiety, 35(6), 560–573.Google Scholar
Flaskerud, J. H., & Winslow, B. J. (1998). Conceptualizing vulnerable populations health-related research. Nursing Research, 47(2), 69–78.Google Scholar
Galea, S., Nandi, A., & Vlahov, D. (2004). The social epidemiology of substance use. Epidemiologic Reviews, 26, 36–52.Google Scholar
Goodyear, K., Haass-Koffler, C. L., & Chavanne, D. (2018). Opioid use and stigma: The role of gender, language and precipitating events. Drug and Alcohol Dependence, 185, 339–346.Google Scholar
Green, K. E., & Feinstein, B. A. (2012). Substance use in lesbian, gay, and bisexual populations: An update on empirical research and implications for treatment. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 26(2), 265–278.Google Scholar
Gunn, A. J., Sacks, T. K., & Jemal, A. (2018). “That’s not me anymore”: Resistance strategies for managing intersectional stigmas for women with substance use and incarceration histories. Qualitative Social Work, 17(4), 490–508.Google Scholar
Hankivsky, O. (2014). Intersectionality 101. The Institute for Intersectionality Research & Policy, SFU.Google Scholar
Hansen, H., & Netherland, J. (2016). Is the prescription opioid epidemic a white problem? American Journal of Public Health, 106(12), 2127–2129.Google Scholar
Haslam, N., & Kvaale, E. P. (2015). Biogenetic explanations of mental disorder. Current Directions in Psychological Science, 24(5), 399–404.Google Scholar
Humensky, J. L. (2010). Are adolescents with high socioeconomic status more likely to engage in alcohol and illicit drug use in early adulthood? Substance Abuse Treatment, Prevention, and Policy, 5, Article 19.Google Scholar
Hunting, G., Grace, D., & Hankivsky, O. (2015). Taking action on stigma and discrimination: An intersectionality-informed model of social inclusion and exclusion. Intersectionalities: A Global Journal of Social Work Analysis, Research, Polity, and Practice, 4(2), 101–125.Google Scholar
Husain, M. O., Zehra, S. S., Umer, M., et al. (2020). Stigma toward mental and physical illness: Attitudes of healthcare professionals, healthcare students and the general public in Pakistan. BJPsych Open, 6(5), e81.Google Scholar
King, T. L., Shields, M., Shakespeare, T., Milner, A., & Kavanagh, A. (2019). An intersectional approach to understandings of mental health inequalities among men with disability. SSM – Population Health, 9, Article 100464.Google Scholar
Lee, R. D., & Rasinski, K. A. (2006). Five grams of coke: Racism, moralism and White public opinion on sanctions for first time possession. International Journal of Drug Policy, 17(3), 183–191.Google Scholar
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.Google Scholar
Lombardi, E. (2007). Substance use treatment experiences of transgender/transsexual men and women. Journal of LGBT Health Research, 3(2), 37–47.Google Scholar
Loya, F., Reddy, R., & Hinshaw, S. P. (2010). Mental illness stigma as a mediator of differences in Caucasian and South Asian college students’ attitudes toward psychological counseling. Journal of Counseling Psychology, 57(4), 484–490.Google Scholar
Marshal, M. P., Friedman, M. S., Stall, R., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103(4), 546–556.Google Scholar
Matthews, S., Dwyer, R., & Snoek, A. (2017). Stigma and self-stigma in addiction. Journal of Bioethical Inquiry, 14(2), 275–286.Google Scholar
Mendoza, S., Hatcher, A. E., & Hansen, H. (2019). Race, stigma, and addiction. In Avery, J. D. & Avery, J. J. (Eds.), The stigma of addiction: An essential guide (pp. 131–152). Springer International Publishing.Google Scholar
Mereish, E. H., & Bradford, J. B. (2014). Intersecting identities and substance use problems: Sexual orientation, gender, race, and lifetime substance use problems. Journal of Studies on Alcohol and Drugs, 75(1), 179–188.Google Scholar
Meyer, I. H. (2007). Prejudice and discrimination as social stressors. In Meyer, I. H. & Northridge, M. E. (Eds.), The health of sexual minorities: Public health perspectives on lesbian, gay, bisexual and transgender populations (pp. 242–267). Springer Science+Business Media LLC.Google Scholar
Meyers, S. A., Earnshaw, V. A., D’Ambrosio, B., Courchesne, N., Werb, D., & Smith, L. R. (2021). The intersection of gender and drug use-related stigma: A mixed methods systematic review and synthesis of the literature. Drug and Alcohol Dependence, 223, Article 108706.Google Scholar
Mitchell, O. (2005). A meta-analysis of race and sentencing research: Explaining the inconsistencies. Journal of Quantitative Criminology, 21(4), 439–466.Google Scholar
Muntaner, C., Eaton, W. W., Miech, R., & O’Campo, P. (2004). Socioeconomic position and major mental disorders. Epidemiologic Reviews, 26, 53–62.Google Scholar
Nash, J. C. (2008). Re-thinking intersectionality. Feminist Review, 89(1), 1–15.Google Scholar
Nash, J. C. (2019). Black feminism reimagined: After intersectionality. Duke University Press.Google Scholar
Ottati, V., Bodenhausen, G. V., & Newman, L. S. (2005). Social psychological models of mental illness stigma. In Corrigan, P. W. (Ed.), On the stigma of mental illness: Practical strategies for research and social change (1st ed., pp. 99–128). American Psychological Association.Google Scholar
Patrick, M. E., Wightman, P., Schoeni, R. F., & Schulenberg, J. E. (2012). Socioeconomic status and substance use among young adults: A comparison across constructs and drugs. Journal of Studies on Alcohol and Drugs, 73(5), 772–782.Google Scholar
Phelan, J. C., Bromet, E. J., & Link, B. G. (1998). Psychiatric illness and family stigma. Schizophrenia Bulletin, 24(1), 115–126.Google Scholar
Pienaar, K., Murphy, D. A., Race, K., & Lea, T. (2018). Problematising LGBTIQ drug use, governing sexuality and gender: A critical analysis of LGBTIQ health policy in Australia. The International Journal on Drug Policy, 55, 187–194.Google Scholar
Potts, L. C., & Henderson, C. (2020). Moderation by socioeconomic status of the relationship between familiarity with mental illness and stigma outcomes. SSM – Population Health, 11, Article 100611.Google Scholar
Purdie-Vaughns, V., & Eibach, R. P. (2008). Intersectional invisibility: The distinctive advantages and disadvantages of multiple subordinate-group identities. Sex Roles, 59(5–6), 377–391.Google Scholar
Rai, S. S., Peters, R. M. H., Syurina, E. V., Irwanto, I., Naniche, D., & Zweekhorst, M. B. M. (2020). Intersectionality and health-related stigma: Insights from experiences of people living with stigmatized health conditions in Indonesia. International Journal for Equity in Health, 19(1), Article 206.Google Scholar
Roe, G. (2005). Harm reduction as paradigm: Is better than bad good enough? The origins of harm reduction. Critical Public Health, 15(3), 243–250.Google Scholar
Ross, M. H., & Setchell, J. (2019). People who identify as LGBTIQ+ can experience assumptions, discomfort, some discrimination, and a lack of knowledge while attending physiotherapy: A survey. Journal of Physiotherapy, 65(2), 99–105.Google Scholar
Saloner, B., & Lê Cook, B. (2013). Blacks and Hispanics are less likely than whites to complete addiction treatment, largely due to socioeconomic factors. Health Affairs (Project Hope), 32(1), 135–145.Google Scholar
Sandelowski, M., Barroso, J., & Voils, C. I. (2009). Gender, race/ethnicity, and social class in research reports on stigma in HIV-positive women. Health Care for Women International, 30(4), 273–288.Google Scholar
Sattler, S., Escande, A., Racine, E., & Göritz, A. S. (2017). Public stigma toward people with drug addiction: A factorial survey. Journal of Studies on Alcohol and Drugs, 78(3), 415–425.Google Scholar
Schomerus, G., & Angermeyer, M. C. (2021). Blind spots in stigma research? Broadening our perspective on mental illness stigma by exploring ‘what matters most’ in modern Western societies. Epidemiology and Psychiatric Sciences, 30, e26. doi.org/10.1017/S2045796021000111Google Scholar
Schomerus, G., Corrigan, P. W., Klauer, T., Kuwert, P., Freyberger, H. J., & Lucht, M. (2011). Self-stigma in alcohol dependence: Consequences for drinking-refusal self-efficacy. Drug and Alcohol Dependence, 114(1), 12–17.Google Scholar
Schomerus, G., Matschinger, H., & Angermeyer, M. C. (2014). Attitudes towards alcohol dependence and affected individuals: Persistence of negative stereotypes and illness beliefs between 1990 and 2011. European Addiction Research, 20(6), 293–299.Google Scholar
Schomerus, G., Stolzenburg, S., Freitag, S., et al. (2019). Stigma as a barrier to recognizing personal mental illness and seeking help: A prospective study among untreated persons with mental illness. European Archives of Psychiatry and Clinical Neuroscience, 269(4), 469–479.Google Scholar
Senia, J. M., Neppl, T. K., Gudmunson, C. G., Donnellan, M. B., & Lorenz, F. O. (2016). The intergenerational continuity of socioeconomic status: Effects of parenting, personality, and age at first romantic partnership. Journal of Family Psychology: JFP: Journal of the Division of Family Psychology of the American Psychological Association (Division 43), 30(6), 647–656.Google Scholar
Sorsdahl, K., Stein, D. J., & Myers, B. (2012). Negative attributions towards people with substance use disorders in South Africa: Variation across substances and by gender. BMC Psychiatry, 12(1), Article 101.Google Scholar
Spooner, C. (2009). Social determinants of drug use – barriers to translating research into policy. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 20(3), 180–185.Google Scholar
Stangl, A. L., Earnshaw, V. A., Logie, C. H., et al. (2019). The Health Stigma and Discrimination Framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine, 17(1), Article 31.Google Scholar
Steinmetz, K. (2020, February 20). She coined the term ‘intersectionality’ over 30 years ago. Here’s what it means to her today. Time. https://time.com/5786710/kimberle-crenshaw-intersectionality/Google Scholar
Sullivan, A. (2017, March 10). Is intersectionality a religion? Intelligencer.Google Scholar
Sullivan, A. (2019, November 15). A glimpse at the intersectional left’s political endgame. Intelligencer.Google Scholar
Turan, J. M., Elafros, M. A., Logie, C. H., et al. (2019). Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Medicine, 17(1), Article 7.Google Scholar
Vargas, S. M., Huey, S. J., & Miranda, J. (2020). A critical review of current evidence on multiple types of discrimination and mental health. The American Journal of Orthopsychiatry, 90(3), 374–390.Google Scholar
Vu, M., Li, J., Haardörfer, R., Windle, M., & Berg, C. J. (2019). Mental health and substance use among women and men at the intersections of identities and experiences of discrimination: Insights from the intersectionality framework. BMC Public Health, 19(1), Article 108.Google Scholar
Wang, K., Rendina, H. J., & Pachankis, J. E. (2016). Looking on the bright side of stigma: How stress-related growth facilitates adaptive coping among gay and bisexual men. Journal of Gay & Lesbian Mental Health, 20(4), 363–375.Google Scholar
Wesselmann, E. D., & Graziano, W. G. (2010). Sinful and/or possessed? Religious beliefs and mental illness stigma. Journal of Social and Clinical Psychology, 29(4), 402–437.Google Scholar
Yang, J. C., Roman-Urrestarazu, A., McKee, M., & Brayne, C. (2019). Demographic, socioeconomic, and health correlates of unmet need for mental health treatment in the United States, 2002–16: Evidence from the national surveys on drug use and health. International Journal for Equity in Health, 18(1), Article 122.Google Scholar

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