Advancing Substance Use Disorder Stigma Research: It's About Time

As a social process, stigma is inherently fluid. It constantly changes and evolves over time. Our theories, research, and interventions, however, frequently treat stigma as stagnant. They often do not consider how experiences of stigma change over time, when experiences of stigma are most harmful to health, or when interventions should be delivered to most effectively address stigma and improve health. Yet, recent calls from the stigma and health disparities literatures emphasize the importance of accounting for time to better understand and intervene in stigma and health disparities. We discuss three timescales for understanding associations between stigma and health: historical or structural context, human development, and status course. We then apply these concepts to research on substance use disorder stigma to illustrate how incorporating a greater focus on time may help to advance our ability to understand and intervene on associations between stigma and health. We further identify methodological challenges and opportunities for integrating time within stigma and health research. Ultimately, we argue that a greater integration of time into stigma research is imperative for researchers to fully understand associations between stigma and health as well as intervene in stigma to eliminate health disparities.