‘That Kind of Role Models it!’ Dynamics of Intergenerational Reinforcement and Disruption of Stigma Towards People Who Use Drugs

Background Stigma towards people who use drugs (PWUD) is a dangerous phenomenon with far-reaching effects. Research shows that parents play a powerful role in the shaping of their children's views of people with mental illness, but no similar research exists to investigate the shaping of views towards PWUD. This qualitative study explores dynamics of intergenerational reinforcement and disruption of stigma towards PWUD. Methods Semi-structured qualitative interviews were conducted with eight people split equally into two categories: 1) Participant-children: people between 18 and 30 and 2) Participant-parents: people of any age with experience as a parent of a child. Participants had some experience of using drugs or alcohol, but this was not a criterion for selection. Interviews elucidated the influence of parents’ views, opinions, narratives, discussions, and disclosures on views towards PWUD. Interviews included questions about stigma and its intergenerational development. Grounded theory was used to analyze the data. Results Three major themes in theory development were elicited for their role in the reinforcement and disruption of stigma towards PWUD: 1) conflation of drug use with other stigmatized characteristics; 2) the telling of stories around problematic drug use; and 3) the use of secrecy or disclosure of personal drug use. Conclusion The results of the study provide an understanding of the dynamics of stigma reinforcement and disruption. Each of the actions described in the themes can work towards either reinforcing or disrupting stigma.