Watch out for the boogieman': multiple stigma and recovery experiences of ethnic minorities with substance use problems

Persons with a migration background and ethnic minorities (MEM) with substance use problems are confronted with stigma due to their ethnicity and/or substance use. While stigma is known to impede recovery from substance use problems, research on the role of living with multiple stigmatized identities on recovery processes of MEM is currently lacking.

We conducted 34 interviews with a diverse sample of MEM with substance use problems in Flanders, Belgium. A qualitative content analysis on the stigma framework by Earnshaw (2020) allowed us to delineate the stigmatized statuses that MEM with substance use problems encounter and the stigma manifestations they experience. We looked into mediating and moderating mechanisms influencing this stigma process and linked these mechanisms to substance use recovery and recovery capital.

The recovery processes of MEM with substance use problems are complicated by accumulated stigma based on different intersectional statuses, namely ethnicity, substance use, psychological problems, criminal histories, poverty, unemployment and gender. This impacts recovery both in a direct (e.g. substance-using coping mechanisms) and indirect manner (through reduced recovery capital). While moderators mentioned by participants were spread across the micro- to macro- continuum (from personal to social, community and macro-cultural features), mediators that influence the role of stigma in recovery were mainly psychosocial.

The multiple, intersectional stigmas that MEM with substance use problems encounter can negatively influence their wellbeing, increase problem substance use and act as a barrier to recovery capital. While individuals and communities may aim to limit the impact of public stigma on recovery through constructive personal and collective coping and action mechanisms, it is pivotal that stigma is reduced by prevention and intervention strategies at macro, meso and micro level.

This research was funded by Fonds Wetenschappelijk Onderzoek (FWO), ref. 3G0A6518.