Perceived discrimination in addiction recovery: Assessing the prevalence, nature, and correlates using a novel measure in a U.S. National sample

Abstract

Background: Alcohol and other drug (AOD) problems are among the most stigmatized conditions globally diminishing help-seeking due to fear of discrimination. Discrimination is common also among people already in AOD recovery, but little is known about the prevalence and nature of perceived discrimination. Greater knowledge would inform treatment and policy.

Method: Nationally representative cross-sectional sample of U.S. adults who reported resolving an AOD problem (final weighted sample n = 2002). Participants were asked, "Since resolving your problem with alcohol or drugs, how frequently have the following occurred because someone knew about your alcohol or drug history?".

Measures: Item response models yielded two types of discrimination: 1. Micro discrimination (personal slights) 2. Macro discrimination (violations of personal rights); psychological distress, quality of life, and recovery capital.

Results: About one quarter of participants reported some type of micro discrimination (e.g., held to a higher standard) with slightly less reporting a violation of personal rights (e.g., couldn't get a job). After adjusting for addiction severity and years since problem resolution, greater micro and macro discrimination were associated with higher psychological distress (β = .45, 95% CI = .35,.55 and β = .59, 95% CI = .45,.73), lower quality of life (β =-.41, 95% CI=-.57,-.26 and β =-.49, 95% CI=-.76,-.21) and recovery capital (β =-.33, 95% CI=-.54,-.12 and β =-.68, 95% CI=-.97,-.40) respectively.

Conclusions: Despite being in recovery, different types of discrimination are experienced. These are associated with increased distress, and lower quality of life and recovery capital. Prospective studies are needed to help clarify the exact nature and impact of such discrimination on AOD problem recurrence.

Keywords: Addiction; Discrimination; Item response modeling; Recovery; Remission; Substance.

Conflict of interest statement

Declaration of Competing Interest

No conflict declared.

Copyright © 2019 Elsevier B.V. All rights reserved.

Figures

Fig. 1.

U.S. prevalence of perceived recovery-related micro discriminations reported by the 9.1% of U.S. adults who have resolved an alcohol or other drug problem.

Fig. 2.

U.S. prevalence of perceived recovery-related macro discriminations reported by the 9.1% of U.S. adults who have resolved an alcohol or other drug problem.