Measuring opioid agonist treatment stigma and its effects: An exploration of pharmacist attitudes and consumer treatment outcomes.

Author: Theresa Caruana

Theme: Social Science & Policy Research Year: 2023

Opioid agonist treatment consumers can experience stigma when collecting and consuming their medications at community pharmacies. We sought to evaluate if pharmacist attitudes and behaviours towards opioid agonist treatment customers influenced consumer perceptions and experiences of treatment effectiveness.

New South Wales community pharmacists were recruited in person, and they assisted in recruiting consumers by distributing study flyers. Surveys were completed by 63 pharmacists and eligible pharmacy opioid agonist treatment consumers completed baseline (n = 132) and follow up surveys (n = 112). Consumer outcomes were analysed at both timepoints with reference to their pharmacist’s responses, their experiences of stigma, and demographic variables.

Pharmacists reported low levels of explicit stigma towards consumers and high levels of support for the treatment model overall, possibly indicating selection and social desirability biases. The number of complete pharmacist attitude measures that could be matched with two or three of their opioid agonist consumers was small (n = 40), which precluded finding any meaningful relationships between pharmacist implicit attitudes and consumer experiences. Although consumers experienced substantial levels of stigma and other hardships due to their medication, they did not report any significant changes in wellbeing or service experiences over time which reflects the stabilising and enduring nature of treatment.

Although stigma is understood to be an important contributor to opioid agonist treatment dissatisfaction, its forms and effects on consumer wellbeing are difficult to measure and evaluate. Stigma experienced by opioid agonist consumers in the treatment setting may be less influential than other sources of social exclusion and discrimination in their lives.

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