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Heroin Addiction and Related Clinical Problems: 2025, 27, 20

Stigma of Opioid Addiction: A Narcoleptic patient was blamed for being excessively sleepy during the day due to her opioid use disorder

Usman Riaz, and Syed Ali Riaz

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2025-20

Summary: Public stigma is driven by stereotypes about people with opioid use disorders, such as their perceived dangerousness or perceived moral failings, which translate into negative attitudes toward people with opioid use disorders. Enacted stigma describes the behavioural manifestations of public stigma, including discrimination and social distancing. Public and enacted stigma, in turn, lead to the delivery of suboptimal care and undermine access to treatment and harm reduction services. When people with opioid use disorders internalise or anticipate the public stigma attached to their illness, maladaptive behaviours (e.g., disengagement from care) leading to poorer health outcomes may occur. Each of these dimensions of stigma (structural, public, enacted, internalised, and anticipated) serves to reinforce each other, resulting in poorer health outcomes even as the epidemiology of opioid overdose mortality continues to change. These dimensions of stigma must be overcome to facilitate the requisite policy and programmatic changes needed to address the opioid overdose crisis effectively and to address other aspects of people’s mental and physical health. Although the epidemiology of opioid use and opioid use disorders (OUDs) has changed over time, the stigma attached to opioid use has endured.

Keywords: OUD (Opioid use disorder); MSLT (Mean sleep latency test); EDS (Excessive daytime sleepiness); OAD (Opioid agonist therapy).