Self-stigma is one of many barriers that affect engagement and retention in OUD treatment and may be driving the high risk of overdose following release from correctional facilities. Identifying factors that moderates and modify post-release opioid related overdose mortality risk can create opportunities for novel interventions and programs. Studies conducted among individuals with a substance use disorder (SUD) have identified fear of enacted stigma, as well as self-stigma, as predisposing factors that hinder treatment entry and engagement. How self-stigma impacts the engagement in OUD treatment following release from jail has not been studied. Less is known on whether a patient-centered primary care model can ameliorate self-stigma and whether this, in turn, enhances improved OUD treatment engagement and retention. This study contributes to a new generation of drug abuse health services research emerging in our group that addresses the effects of self-stigma on the effectiveness and patient-centeredness of a new primary care-based approach to improving the health of justice-involved individuals with OUD. The overall research objective of this supplement to parent grant (1UG1DA050072) is to examine the effects of self- stigma on the OUD treatment cascade among individuals just released from jail and assess if the TCN intervention is associated with self-stigma reductions during post release treatment period.
We aim to: (1) Identify which sociodemographic characteristics and psychosocial, health, and treatment factors are associated with self-stigma. (2) Determine whether self-stigma moderates the association between TCN participation and engagement in OUD treatment following release. Results will provide preliminary data for a subsequent R34 testing an intervention to ameliorate self-stigma and its impact on treatment outcomes. The professional development plan will facilitate attainment of the applicant?s independent research career focused on testing intervention modalities accessible in primary care to reduce self-stigma and enhance pursuing valued life goals in this vulnerable population.
The proposed study is distinctive, innovative, and relevant to public health in light of the limited knowledge available on the role of self-stigma on the opioid use disorder (OUD) treatment cascade among individuals just released from jail. The project is relevant to NIDA?s mission-driven strategic goals to improve OUD treatment among this high-risk population and to optimize clinical research to improve health and reduce disease. This study will provide data for the future development and testing of patient-centered interventions targeting self- stigma in OUD treatment participants that enhance their retention in treatment.
