Mental Health and Welfare Center, City of Yokohama, Yokohama, Japan.
Department of Drug Dependence Research, Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.
Neuropsychopharmacol Rep. 2023 Dec;43(4):576-586. doi: 10.1002/npr2.12380. Epub 2023 Oct 9.
Stigma within healthcare settings significantly impact the lives of people who use drugs (PWUD). Given the lack of quantitative data on stigma toward PWUD in healthcare settings and the unknown factors that contribute to it in the Japanese context, this study aimed to investigate the current status of stigma toward PWUD and its determinants.
We conducted a survey in five specialized addiction medical facilities across three prefectures in Japan. The survey included questions related to stigmatizing attitudes toward PWUD, knowledge about illicit drug use, and personal and professional interactions with PWUD.
A substantial portion of respondents rejected the notion that drug addiction can be overcome through sheer willpower or attributed it solely to moral failings. However, the majority still considered them untrustworthy and viewing drug use as unacceptable and incomprehensible. Many respondents perceived PWUD as dangerous, despite the limited occurrence of hostile behavior from PWUD in clinical practice. A considerable proportion of respondents did not seek support for their own or their relatives' drug-related issues, and less than half had collaborated with recovered PWUD, which serves as potential indicators of reduced stigma. While healthcare professionals recognized that involving law enforcement does not contribute to the recovery of PWUD, a considerable number still believed it was necessary to report them to the authorities.
Healthcare professionals in specialized addiction medical facilities demonstrate strong stigmatizing attitudes toward PWUD. Comprehensive educational programs and large-scale awareness campaigns are necessary to address and mitigate stigma in this context.
医疗环境中的污名化现象对吸毒者（PWUD）的生活产生了重大影响。鉴于日本缺乏针对医疗环境中对 PWUD 的污名化的定量数据，以及未知的促成因素，本研究旨在调查当前对 PWUD 的污名化现状及其决定因素。
我们在日本三个县的五家专门的成瘾医学机构进行了一项调查。该调查包括与对 PWUD 的污名化态度、关于非法药物使用的知识以及与 PWUD 的个人和专业互动相关的问题。
相当一部分受访者拒绝了仅仅通过意志力或道德缺陷就可以克服毒瘾的观点，但仍有多数人认为他们不可信，认为吸毒是不可接受和不可理解的。尽管在临床实践中 PWUD 很少表现出敌对行为，但许多受访者仍认为他们很危险。相当一部分受访者没有为自己或亲属的吸毒问题寻求支持，只有不到一半的人曾与康复的 PWUD 合作，这可能表明污名化程度有所降低。尽管医疗专业人员认识到让执法部门参与并不会促进 PWUD 的康复，但仍有相当数量的人认为有必要向当局报告他们。
专门的成瘾医学机构的医疗保健专业人员对 PWUD 表现出强烈的污名化态度。在这种情况下，需要开展全面的教育计划和大规模的宣传活动，以解决和减轻污名化问题。
