Stigma and Health Among Black Adults Who use Opioids: A Latent Class Analysis

Background: Stigma can be detrimental to health and wellbeing. Black adults experience various forms of stigma, such as stigma related to receiving psychological help. Stigma prevents treatment initiation, exacerbates psychological distress, and leads to adoption of unhealthy coping mechanisms, such as opioid misuse. Objectives: Given the rise in opioid-related overdose deaths among Black adults, the present study aims to examine stigma related to receiving psychological help and its association with depression, anxiety, opioid use, and treatment-related variables among Black adults. Method: Informed by Goffman's Social Stigma theory, stigma classes related to receiving psychological help were examined with a latent class analysis (LCA). Stigma class and its relationship with opioid misuse, anxiety, depression, barriers to treatment, and healthcare distrust was examined. Participants were 809 Black adults stratified by age and sex who reported opioid misuse in the past six months. Results: The "high stigma" class was significantly associated with a 1.44 times greater likelihood of recent opioid misuse, more barriers to treatment, and greater healthcare distrust than the "low stigma" class. Sex and age were also highlighted as covariates associated with opioid misuse, mental health, barriers to treatment, and healthcare distrust. Conclusions: Experiencing stigma related to receiving psychological help appears to influence health outcomes, such as opioid misuse. It is also connected to experiencing barriers to treatment, making it crucial to focus on stigma experienced among Black adults to minimize negative health and treatment consequences.