Stigma and disaster risk reduction among vulnerable groups: Considering people receiving opioid substitution treatment

Abstract

This work explores the ways in which stigma influences how people engage with disaster risk reduction. It specifically addresses the experiences and perceptions of stigma for people who receive Opioid Substitution Treatment (OST), a successful harm reduction strategy that reduces illicit drug use, risk of overdose and criminal activity. Unfortunately, while receiving OST people endure stigma because of their perceived or assumed history of drug use, which positions them as socially deviant and unacceptable. During a disaster or emergency, forms of social stigma from health and emergency management personnel have implications for access to treatment such as OST. Drawing on semi-structured interviews with 21 people receiving OST from services in four major cities in Aotearoa New Zealand, an interpretive analysis was applied to better understand how stigma matters to their lived experience. Four key themes, namely “Experiences of stigma”, “Discrimination from health professionals”, and “Disasters and emergency management” and “Support within disaster contexts” were identified in their talk. We conclude that it is vital that medications and other necessary treatments are made accessible to those who need them to maintain health and wellbeing. It is important to be aware that stigmatising beliefs manifest in disaster-response settings which have consequences for people who are already more vulnerable than others. Therefore we suggest that appropriate education and training be provided.