發佈日期︰2021-07-02 │ 發佈人︰後台管理員

The Impact of Stigma on Treatment Services for People With Substance Use Disorders During the COVID-19 Pandemic—Perspectives of NECPAM Members

Stigma is a mark of shame, disgrace, or disapproval which results in the individual being rejected, discriminated, and excluded from society. For the individual with Substance Use Disorder (hereinafter is abbreviated to SUD), the stigma affects his emotion, mentality, and physical health. 

 

People with SUD are often viewed as unpredictable, dangerous, and morally responsible for their conditions. These prejudices and discriminatory views of the community may lead to reduce the access to care, be unable to make decisions regarding treatment or compulsory treatment. Furthermore, stigma negatively affects the policies and programs intended for the management of SUD and other ADs (hereinafter called addictive disorders). Moreover, people with ADs may develop self-stigma for their behavior, including the decreased use of healthcare services as a consequence of poorer health outcomes. 

 

Internalized stigma and self-stigma have been linked to the increase in psychological distress and poorer quality of life. People with SUD, in particular, may face significant stigmatization by healthcare practitioners. A significant concern during the COVID-19 pandemic is that can not provide adequate care for both the people with AD and concurrent COVID-19. Therefore, people with SUD may be experiencing increased stigmatization in different countries during the COVID-19 pandemic. This exacerbated stigma and discrimination toward people with SUD may lead to inadequate care or less attention from the clinicians, policymakers, and other stakeholders. 

 

To explore this important issue, in March 2020, members of the Network of Early Career Professionals working in the area of Addiction Medicine (NECPAM) were asked to share their experiences, observations, relevant published literatures, and opinions from their respective Countries, i.e., Italy, India, Nepal, Morocco, South Africa, Egypt, Ireland, Indonesia, Japan, and New Zealand.

 

During the COVID-19 pandemic, SUD and behavioral addictions had not been featured significantly in policy and program planning in most settings including Indonesia. The individuals with SUD and other ADs, the stigma was thought to be one of the causes which these individuals may be seen as less deserving of care. Indonesia reported that individuals with substance use and behavioral ADs were often faced with restrictions of access to healthcare services. Although some protocols were developed for people with SUD during the COVID-19 pandemic, no policies made to coordinate services for people with behavioral addictions. 

 

The absence of specific protocols for people with behavioral addictions during the beginning of pandemic was regrettable. Therefore, the Indonesian government has released a specific protocol of HIV-AIDS health services during COVID-19, and the Indonesian Psychiatric Association published in tandem the practical guidance for a psychiatrist in COVID-19 healthcare centers which also provides the service for the  patients with ADs.

 

Reframing the policy or guidelines to create a balance for the services between COVID-19 pandemic and AD is needed, and to provide an affordable, safe, accessible, and effective care for people with SUD. In addition, it is also required to reduce the stigma toward people with SUD and to enhance the access to care during the pandemic.

 

link https://www.frontiersin.org/articles/10.3389/fpsyt.2021.634515/full

source: Frontiers in Psychiatry