Understanding Substance Use Stigma: A Comprehensive Review 

Substance use stigma significantly hinders effective treatment and recovery for individuals struggling with addiction. In a recently released paper from Angelica Spata, Jason Luoma Ph.D., Kati Lear Ph.D., and Brian Pilecki Ph.D., all researchers at Portland Psychotherapy, "Substance Use Stigma: A Systematic Review of Measures and Their Psychometric Properties," explores the complexities of substance use stigma and evaluates the tools used to measure it.  

Substance use stigma manifests in various forms, including structural stigma, social stigma, and internalized stigma. Structural stigma involves policies and institutional practices that disadvantage people who use substances. Social stigma refers to public attitudes and behaviors that dehumanize and ostracize substance users. Internalized stigma occurs when individuals internalize these societal negative perceptions, leading to self-shame and decreased self-worth. 

Our systematic review identified 18 measures designed to assess substance use stigma and related shame. However, we found significant gaps in their psychometric evaluations. Most measures had limited evaluations across crucial domains such as cross-cultural validity and test-retest reliability. Additionally, none of the identified tools effectively measured structural stigma, which is a critical area impacting policy and practice. Evidence supporting the measures' validity was often weak, with many relying on adapted items from mental illness stigma scales without proper validation for substance use contexts. 

Despite these limitations, our review highlighted some measures with satisfactory psychometric properties. To advance the understanding and measurement of substance use stigma, we recommend developing and validating measures for structural stigma, ensuring that stigma measures are valid across different cultural contexts, and focusing on evaluating the responsiveness of stigma measures to various interventions. 

In conclusion, substance use stigma remains a pervasive barrier to treatment and recovery. While existing measures provide a foundation, there is a critical need for more robust, comprehensive tools that can accurately capture the multifaceted nature of this stigma. Our review underscores the importance of continued research and development in this area to support better outcomes for individuals with substance use disorders. 

For more detailed insights, please refer to our full paper available in Drug and Alcohol Dependence Reports.