“They don’t think much of you if you’re using”: Stigma among criminalised people who smoke methamphetamine in Victoria, Australia

Background In Australia, methamphetamine (‘ice’) use has been framed as a major social problem, contributing to punitive policy responses and ongoing criminalisation through which stigma is enacted. Although smoking is the predominant route of use, little is known about how people who smoke methamphetamine experience stigma. Methods In-depth interviews were conducted with nine people with histories of smoking methamphetamine, no lifetime history of injecting drug use; and prior interactions with the criminal legal system in Victoria, Australia. Interviews explored experiences of drug use and treatment, criminal legal involvement, stigma and wider social and economic conditions. With stigma as the primary analytic focus, data were thematically analysed using Iterative Categorisation. Results Findings demonstrated how stigma impacted participants' lives in multiple and intersecting ways, shaping their experiences across personal relationships and institutional settings. Stigma was enacted through criminal legal practices that normalised surveillance and neglect, social relationships marked by exclusion and conditional support, and gendered judgements that intensified moral scrutiny of women who use methamphetamine. Across these contexts, participants described experiences of stigma that limited their access to care, protection, and social support. Three themes were identified: 1) “You’re just treated like an animal”: Institutional stigma in policing; 2) “Everyone’s calling me a crackhead, I’ll go and be one”: Social and relational stigma; 3) “It was kind of like everyone turned against me”: Gendered stigma among women. Conclusion Participants’ experiences of stigma extended beyond isolated interpersonal encounters and were embedded within institutional practices and social relationships. These findings highlight how participants experienced stigma as reinforcing inequities in access to care, protection, and social support across social and institutional settings.