2026-2027 | On-Demand Session | Stigma and Discrimination in Addiction | July 2026-Stigma and Discrimination Recording 2026

Video Transcription

Video Summary

Dr. Miki Kiyokawa gave an interactive lecture on stigma and discrimination in addiction medicine, using four clinical cases to show how prejudice affects care. She defined stigma as viewing people negatively because of substance use disorder (SUD), and discrimination as treating them negatively because of it.<br /><br />She reviewed evidence that the public, policymakers, and even healthcare workers often hold harmful beliefs about people with SUD, including assumptions that they are violent, manipulative, or not deserving of treatment. She also highlighted how underfunding and weak policy support worsen access to treatment.<br /><br />The first two cases focused on benzodiazepine prescribing and surgical care. In one, a patient’s report of prescribed benzodiazepine use was doubted because the PDMP was incomplete, delaying treatment and contributing to an against-medical-advice discharge. In another, two similar patients with endocarditis were treated differently: one received surgery after respectful communication, while the other was refused surgery because of substance use history, illustrating how provider attitudes can shape outcomes.<br /><br />The third case involved an older man whose opioid use escalated after surgery. He benefited from buprenorphine, but stigma from staff calling him a “junkie” led him to consider stopping treatment and switching back to full agonist opioids. The final case showed how hospitalized patients may use drugs in the hospital when pain, withdrawal, or stigma are not addressed. It emphasized balancing safety with patient-centered, non-punitive policies.<br /><br />The talk concluded that education, respectful language, appropriate MOUD use, trauma-informed care, and clear hospital policies are key strategies to reduce stigma and improve outcomes for patients with SUD.

Keywords

stigma

discrimination

addiction medicine

substance use disorder

benzodiazepines

prescription drug monitoring program

endocarditis

surgery

buprenorphine

opioid use

medication for opioid use disorder

trauma-informed care

hospital policy