The Role of Physician and Nurse Attitudes in the Health Care of Injecting Drug Users

School of Psychology and National Centre in HIV Social Research, University of New South Wales, Sydney, New South Wales, Australia.
Substance Use & Misuse (Impact Factor: 1.23). 06/2010; 45(7-8):1007-18. DOI: 10.3109/10826081003659543
Source: PubMed


In 2005, 60 health care workers were recruited through services that attract injecting drug users (IDUs) and asked to complete attitude measures regarding IDU clients. Mediation analyses indicated that conservative health care workers displayed more negative attitudes toward their IDU clients because they believe that injecting drug use is within the control of the IDU. Negative attitudes toward IDU clients, in turn, were associated with worry about IDU clients' behavior in the clinic and with beliefs that IDU clients should disclose their hepatitis C status to their health care worker. Perceptions of controllability of drug use were also associated with the belief that IDU clients' ailments were caused by their IDU status. The study's limitations are noted.

Download full-text


Available from: Susan Kippax
  • Source
    • "One study identified beliefs of drug users as violent, having weak characters, being unhygienic, having contagious diseases, and being dangerous to be the most strongly endorsed stereotypes among hospital nurses (Natan et al. 2009). Importantly, prejudice is associated with stereotypes such that healthcare workers who are more prejudiced are also more likely to endorse drug use stereotypes and therefore worry that injection drug use clients will misbehave in treatment settings (e.g., act violently; Brener et al. 2010). Discrimination includes behavioral expressions of prejudice directed towards people with a history of drug addiction and can range from subtle (e.g., gossip) to extreme (e.g., job loss, social ostracism). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources as well. Because stigma has important implications for the mental health and recovery efforts of people in treatment, it is critical to better understand these experiences of stigma. Therefore, we characterize drug addiction stigma from multiple sources using qualitative methodology to advance understandings of how drug addiction stigma is experienced among methadone maintenance therapy patients and from whom. Results demonstrate that methadone maintenance therapy patients experience prejudice, stereotypes, and discrimination from friends and family, coworkers and employers, healthcare workers, and others. Discussion highlights similarities and differences in stigma experienced from these sources.
    Full-text · Article · Feb 2013 · International Journal of Mental Health and Addiction
  • Source
    • "Perceiving staff as non-threatening and supportive appears to be important for ongoing engagement of clients in treatment [16] and continuing after-care [25]. Health-care workers report that injecting drug users are often their most difficult clients, as they expect them to be more dangerous, less cooperative, more aggressive, less truthful, less likely to complete treatment and more demanding than other clients [26] [27]. It is thus unsurprising that health workers show evidence of negative unconscious attitudes toward their drug-injecting clients even when they report no conscious negative attitudes towards them [28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Staff interactions with their clients are an important factor in the quality of care that is provided to people in drug treatment. Yet there is very little research that addresses staff attitudes or clients' perceptions of discrimination and prejudice by staff with regard to treatment outcomes. This research aimed to assess whether perceptions of discrimination by staff predict drug treatment completion. The study used a mixed methods approach. Ninety-two clients in residential rehabilitation facilities in Sydney were administered a series of quantitative measures assessing drug history, severity of drug use, treatment history, perceptions of staff discrimination and treatment motivation. Clients were followed up regularly until an outcome (dropout or completion) was obtained for the full sample. Perceptions of discrimination were a significant predictor of treatment completion, with greater perceived discrimination associated with increased dropout. Qualitative interviews with 13 clients and eight health-care workers from these treatment services were then conducted to gain insight into how perceived discrimination may impact on treatment experiences. Clients and staff discussed how they would address the issue of perceived discrimination during the current treatment experience. Adopting a mixed methods approach facilitated exploration of the impact of perceived discrimination on treatment from both clients' and health-care workers' perspectives. This methodology may also enhance interpretation and utilisation of these findings in drug treatment.
    Full-text · Article · Sep 2010 · Drug and Alcohol Review
  • [Show abstract] [Hide abstract]
    ABSTRACT: Stigma continues to be the largest barrier for accessing treatment among people experiencing drug addiction. The dominant portrayals that exist about people who use drugs are often damaging and act to dehumanize the group as a whole. When left unchallenged, stereotypes can act as truthful depictions and facilitate the resistance against harm reduction services that are based on a human rights model. The use of labels is one way stigma is perpetuated by eliciting the label's stereotyped narratives onto an individual or group. Within harm reduction discourse, the word "addict" can have detrimental effects on how the public perceives people experiencing addiction and their deservingness of pragmatic services. This article aims to draw attention to the inattention we give "addict" in language and explain how its routine use in society acts to perpetuate addiction stigma. Using the example of supervised injection site opposition in Canada, the use of "addict" is used as a way to understand how stigma through language works to impede the expansion of harm reduction initiatives.
    No preview · Article · Apr 2013 · Journal of Addictions Nursing
Show more