# A comparative appraisal of stigma among healthcare workers towards alcohol and substance use disorders: a case vignette study

## TL;DR

This study compares how healthcare workers stigmatize alcohol and substance use disorders, finding higher stigma for substance use.

## Contribution

This is the first study to compare stigmatization patterns of alcohol and substance use disorders among healthcare workers.

## Key findings

- Substance use disorder was perceived as more severe than alcohol use disorder.
- Participants associated substance use with aggression and inability to recover.
- Stigma was higher for substance use, leading to greater social distancing.

## Abstract

Alcohol and substance use disorders contribute significantly to the global burden of disease, resulting in substantial morbidity and mortality. Meanwhile, stigmatization is a major barrier to treatment and incorporation into community life processes. Given that stigma among health care workers may affect patients’ access to adequate healthcare services, this study aimed to evaluate the stigma patterns regarding alcohol and substance use disorders.

This descriptive study was conducted at a tertiary health facility. Two identical case vignettes were prepared to evaluate the possible differences in stigma patterns of alcohol and substance use disorders. The target population included physicians, nurses, and other healthcare workers. A total of 396 voluntary participants completed the study.

The proportion of participants who stated that substance use disorder was a more severe illness was significantly higher, while alcohol use disorder was considered to be more associated with socioeconomic problems. Similarly, participants felt that substance use patients should not freely roam in the community, were more aggressive, and cannot make sound decisions in life. Finally, patients with substance use disorders were seen as unable to recover completely.

To the best of our knowledge, this is the first study to evaluate differences of stigmatization patterns regarding alcohol and substance use disorders among healthcare workers. The study showed that the stigma associated with alcohol and substance use disorders was high, while substance use was also associated with higher levels of unacceptability and greater social distancing. These findings can be used in developing health policies and enhancing educational strategies.