Examining the Relationship Between Acceptance of Different Models of Addiction and Individual Stigma Among Outpatients With Alcohol and Opioid Use Disorders

Individual stigma regarding addiction has been identified as a barrier to treatment seeking for individuals with substance use problems. Evidence exists that different conceptual models of addiction (MOAs, e.g., brain disease model) and reasons for seeking treatment are associated with individual stigma. The present study tested whether acceptance of different MOAs is associated with individual stigma among alcohol and/or opioid use disorder (AUD and/or OUD) outpatients. Participants were 108 adults (M-age = 44.57 years, 48.6% women) who previously sought treatment for an AUD or OUD (two groups: AUD group and "opioid-involved" group including individuals with an OUD or comorbid AUD/OUD). An online survey assessed beliefs in five MOAs (i.e., disease, moral, psychological, sociological and nature), reasons for seeking treatment, and three types of individual stigma. Individual stigma ratings were significantly higher in the opioid-involved group. Greater beliefs in the nature MOA (e.g., natural predisposition to alter our state of consciousness) and psychological MOA (e.g., due to life stress and abnormal coping mechanisms) related to lower internalized stigma for both groups and greater enacted stigma for the AUD group, respectively. Greater external motivation is related to greater enacted and anticipated stigma scores, whereas greater introjected motivation is related to greater internalized stigma. Individual stigma was greater for those with an OUD. Greater beliefs that addiction is a natural problem related to lower individual stigma. This research provides important insight into which MOAs protect against individual stigma and may be adopted into prevention programs to protect those suffering from addictions.