'Once a drug addict, always a drug addict': the role of stigma in recovery

Although drug using is decriminalized in Portugal, people who use drugs are still stigmatized. Despite the existence of some approaches that explore the topic of stigma and drug use, there seems to be a need for more qualitative approaches that explore not only stigma, but it’s impact on the recovery of people who use drugs as well. Therefore, we listened to the experiences and opinions of people who are enrolled in an opioid treatment program to understand how this stigma affects their treatment, in what situations do they feel it more present and what could be done to address this issue.

This longitudinal research is inserted in a larger European project, DURESS (Drug Use Recovery, Environment and Social Subjectivity), funded by SICAD (General Directorate for Intervention on Addictive Behaviours and Dependencies) and implemented by Faculdade de Psicologia e Ciências da Educação, Oporto University. Health diaries were the methodological strategies used and each participant was involved for a period of around 6 months. We recruited 25 participants and ended up having 14 people actively participating in writing the health diaries.
Diaries suggested some topics to address but participants were free to select what was important to mention and what was not. People involved could also choose to write down themselves or to meet weekly with the researcher to share how treatment was being experienced, what were the influential socio-environmental factors and how the experience could be improved. One of the suggested topics is stigma and discrimination, that is the focus of this study.

Data were analyzed through content analysis. The results suggest that experiences of discrimination and stigmatization relate to negative feelings and have an impact on thoughts/desires about consuming illicit drugs, alcohol or pharmaceutical drugs. One of the most common places for stigmatization to occur is in health care services, due to the stigma being more likely to be recognized. Stigmatization also occurs in other contexts, such as family, workplace and through contact with the authorities.