Most people know about public stigma, which is defined as society’s negative attitudes towards a group of people. But less well-known is the concept of structural stigma. This refers to the role stigma plays in a person’s ability to seek and receive treatment for their chronic illness. Systems-level discrimination from institutional policies create structural stigma, and that can be a powerful force that prevents individuals with substance use disorders from getting the help they need.
As part of these efforts, Michigan OPEN, in collaboration with Shatterproof’s National Stigma Initiative, hosted a Stigma, Maternal Health, and the Opioid Crisis webinar a couple of weeks ago, on July 8.
Michigan OPEN is an organization that works to prevent chronic opioid use throughout Michigan by developing better clinical pathways, reducing the surplus of opioid pills within communities, and educating patients and providers. With the safety net system in Michigan still recovering from the COVID-19 pandemic that put restrictions on in-person support groups and availability in rehab facilities, this work is more important than ever.
The webinar was facilitated by Shatterproof’s National Stigma Initiative Vice President, Matthew Stefanko, and included an introduction by Dr. Jennifer Waljee, Co-director of Michigan OPEN. In her introduction, Dr. Waljee emphasized the importance of continued programming on the topic of stigma. “As a practicing surgeon, I think the topic of stigma and the way our patients experience care plays out every single day in our care settings. Conversations like the one we’re having today are really important for us to understand how we can build the best care pathways for our patients.”
When speaking to the care she received from an emergency department nurse who treated her on the day she decided to seek treatment for her opioid use disorder, Kim emphasized that it was the nurse’s compassion and judgement-free demeanor that empowered her to move forward with treatment. Kim went on to recognize that not all providers have treated her with the same level of empathy. “There is a label that has followed me since I entered recovery. [Providers] hear ‘addict’ first, and they do not hear anything else that I am going in to be treated for. They put up a red flag.”
Next, Dr. Courtney Townsel, Assistant Professor at the University of Michigan, and Dr. Neel Shah, Assistant Professor at Harvard Medical School led a panel discussion. Perhaps one of the most stigmatized groups of people as it relates to those who use substances are pregnant people, and Dr. Townsel and Dr. Shah, who are both obstetricians by training, are all too familiar with the role that stigma can play in their patients’ ability to receive appropriate care. Stigma perpetuated by providers can lead to delayed diagnosis, worse outcomes, and a general mistrust of the healthcare system. Both Dr. Shah and Dr. Townsel spoke to the importance of educating providers on how to use patient-centered language that avoids labeling and negative connotations, as well as how to reframe their perspectives when treating pregnant patients who use substances. Most importantly, care needs to be delivered in a way that treats all the individual’s needs, rather than solely focusing on their disease.
As an organization, Shatterproof is excited to collaborate with Michigan OPEN in delivering programming that spreads awareness to the importance of patient-centered care and person-first language with the goal of ultimately reducing addiction-related stigma, while also shedding light on the various layers of stigma that too often exist in clinical settings.
The interactive workshop will focus more specifically on the personal impact of stigma and strategies for recognizing and eliminating stigma in your daily life. If this topic interests you, don’t miss your chance to register!
Ashley Narvaez is a Program Coordinator for Shatterproof’s National Stigma Initiative.