ArticleThe International journal on drug policy2025
"Stigma is our most powerful enemy": Understanding opioid use disorder stigma and the role of peer support in rural Maryland.
Article in The International journal on drug policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Pilot evaluation of a pharmacist-led technical assistance program to address buprenorphine dispensing in community pharmacies.Exploratory research in clinical and social pharmacy · 2026Article
- Substance use stigma mechanisms associated with greater depressive symptoms, substance use-related problems, and lower behavioral activation.Addictive behaviors reports · 2026Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionRural areas of the U.S. face persistent challenges with opioid-related fatalities and opioid use disorder (OUD) treatment retention. One significant barrier is stigma surrounding OUD and its treatment. Rural areas may face unique structural and geospatial stigmas that impact OUD and care. Peer recovery specialists (PRSs), individuals with lived substance use and recovery experience, may offer support in overcoming stigma-related barriers to recovery in these areas, yet little is known about if and how PRSs can support these efforts. This qualitative study aimed to understand: 1) how multiple levels of stigmas manifest amongst patients receiving OUD treatment in an innovative telemedicine rural mobile treatment unit; 2) how stigmas influence treatment experiences; and 3) if and how PRS engagement may ameliorate stigma-related barriers.
methodsSemi-structured interviews were conducted with 25 patients and 5 staff members, and transcripts were analyzed using inductive thematic analysis.
findingsFindings demonstrated the pervasive impact of multiple stigmas (e.g., OUD, polysubstance use, and other identity-related stigmas), enacted by numerous sources (e.g., pharmacists, family, physicians), on OUD treatment initiation and outcomes. These were uniquely influenced by rural living conditions, including low access to alternative healthcare options, the small, insular social environment, limited privacy, and reluctance to help-seeking. Participants expressed that, through their shared lived experience, PRSs can help patients overcome stigma through increased trust and rapport, teaching coping strategies, and instilling hope.
conclusionsUnderstanding rural patient experiences with multi-layered stigmas is crucial for developing innovative strategies to reduce stigma and support recovery.
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Registered trials
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