Stigma and Discrimination in Addiction (2025-2026 Recording)-Stigma and Discrimination Recording

Video Transcription

Video Summary

The speaker, Miki Kiyokawa from the University of Hawaii Addiction Medicine Fellowship, delivered an interactive lecture on stigma and discrimination toward patients with substance use disorder (SUD). Using fictionalized but realistic clinical cases, she showed how bias affects public opinion, policymaking, and healthcare delivery.<br /><br />She first explained the difference between stigma (negative beliefs) and discrimination (negative treatment), then highlighted studies showing that many people view individuals with SUD as violent, immoral, or unwilling to change, and often oppose treatment funding. She also described how healthcare systems underfund addiction care compared with other diseases.<br /><br />Three main cases illustrated these issues. In the first, a hospitalized patient’s benzodiazepine use was doubted because of a history of heroin use, leading to delays and distress before the truth was confirmed. In the second, two patients with endocarditis and injection drug use were treated differently by surgeons; one received care after respectful counseling, while the other was denied surgery due to perceived “poor commitment” to treatment. In the final case, an older man stabilized on buprenorphine was called a “junkie” in a skilled nursing facility and stopped his effective treatment because of the stigma.<br /><br />Her key message was that stigma harms patients, reduces treatment engagement, and can worsen outcomes. She emphasized that education, respectful language, curiosity, multidisciplinary communication, and treating SUD like any other chronic illness are essential. The talk ended with the reminder that words can hurt as much as physical injuries: “sticks and stones” may break bones, but words can damage care and recovery too.

Keywords

stigma

discrimination

substance use disorder

addiction medicine

bias

healthcare delivery

buprenorphine

endocarditis

injection drug use

patient care

treatment engagement

respectful language