ArticleHarm reduction journal2024
The relationship between felt stigma and non-fatal overdose among rural people who use drugs.
Article in Harm reduction journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The trial behind it
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Who cites it
12 citing papers in PubMed, 14 citations in OpenAlex.
- The Association of Perceived Risk for Opioid Overdose and Subsequent Overdose Among a Cohort of Opioid Overdose Survivors Who Use Nonprescribed Opioids.Substance use & addiction journal · 2026Trial
- Promoting substance use stigma resistance through an automated text message intervention (project RESTART): Outcomes of a pilot feasibility trial.Journal of substance use and addiction treatment · 2025Trial
- History of Naloxone Possession Among Rural and Urban Individuals Participating in Prison-Based Treatment: An Observational Study.Substance use & addiction journal · 2026Observational
- Substance use stigma mechanisms associated with greater depressive symptoms, substance use-related problems, and lower behavioral activation.Addictive behaviors reports · 2026Article
- "Stigma's Every Day, All Day Long": A Qualitative Exploration of Experiences of Overlapping Stigmas and HIV Prevention Service Use Among Women Who Use Drugs.Stigma and health · 2026Article
- Article
- Patterns of Felt Stigma Among Rural-Dwelling People Who Use Drugs: A Latent Class Analysis.Substance use & misuse · 2026Article
- "Stigma is our most powerful enemy": Understanding opioid use disorder stigma and the role of peer support in rural Maryland.The International journal on drug policy · 2025Article
- Mapping the lived experience of rural substance use stigma: A conceptual framework of salient attitudes, beliefs, and behaviors in people who use drugs.Social science & medicine (1982) · 2025Article
- A cross-sectional study of stigma towards opioid users among rural law enforcement and community members in tennessee.Harm reduction journal · 2024Article
- An Automated Text Messaging Intervention to Reduce Substance Use Self-Stigma (Project RESTART): Protocol for a Feasibility and Acceptability Pilot Study.JMIR research protocols · 2024Article
- 'It was like coming back from the clouds': a qualitative analysis of the lived experience of overdose consequent to drug use among a cohort of people who use drugs in Scotland.Harm reduction journal · 2024Article
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundDrug overdose deaths in the United States exceeded 100,000 in 2021 and 2022. Substance use stigma is a major barrier to treatment and harm reduction utilization and is a priority target in ending the overdose epidemic. However, little is known about the relationship between stigma and overdose, especially in rural areas. We aimed to characterize the association between felt stigma and non-fatal overdose in a multi-state sample of rural-dwelling people who use drugs.
methodsBetween January 2018 and March 2020, 2,608 people reporting past 30-day opioid use were recruited via modified chain-referral sampling in rural areas across 10 states. Participants completed a computer-assisted survey of substance use and substance-related attitudes, behaviors, and experiences. We used multivariable logistic regression with generalized estimating equations to test the association between felt stigma and recent non-fatal overdose.
results6.6% of participants (n = 173) reported an overdose in the past 30 days. Recent non-fatal overdose was significantly associated with felt stigma after adjusting for demographic and substance use-related covariates (aOR: 1.47, 95% CI: 1.20-1.81). The association remained significant in sensitivity analyses on component fear of enacted stigma items (aOR: 1.48, 95% CI: 1.20-1.83) and an internalized stigma item (aOR: 1.51, 95% CI: 1.07-2.14).
conclusionsFelt stigma related to substance use is associated with higher risk of non-fatal overdose in rural-dwelling people who use drugs. Stigma reduction interventions and tailored services for those experiencing high stigma are underutilized approaches that may mitigate overdose risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.