UNITE Against SUD Stigma

To get started with the course, click on the 'Tests' tab and follow the instructions to 'Launch Website' and complete the 'Post Test' for each module. If you have completed the course modules through your facility's learning management system, you can complete the 'Post Test' for each module and complete the post-assessment for the training series to claim your continuing education credits.

The UNITE Against SUD Stigma training modules were developed by the Marion County Public Health Department as part of the Substance use Stigma Assessment and Response (SSAR) project. This training contains five mini modules that each take about 10 minutes to complete. Each module dives deeper into one letter of the UNITE acronym, which stands for: 

Uncover your bias 

Notice stigmatizing language 

Identify and share resources 

Take time to recharge 

Empathize and empower 

Goal: One of the main goals of the SSAR project is to create a training experience that educates and empowers healthcare professionals to humanize patients with SUD and develop practical skills to interact with and treat these patients. 

Impact: The SSAR project anticipates the impact of these anti-stigma trainings will humanize patients with SUD by providing personal stories, resources, and education to neutralize harmful perspectives.

 To learn more about the SSAR project visit https://marionhealth.org/ssar/. Questions and comments can be directed to Mandy Billman, [email protected]. 

Launch Date: 12/8/2023

Expiration Date: 12/7/2025

1. Learn about SUD-related stigma, evaluate personal bias towards PWSUD, and understand how stigma impacts quality of care. (Module 1: Uncover your bias)
2. Understand person-first language and how to use it to replace commonly used stigmatizing terms in relation to PWSUD. (Module 2: Notice stigmatizing language)
3. Identify and share harm reduction and SUD treatment resources. (Module 3: Identify and share resources)
4. Choose a breathing, grounding, or self-care opportunity that works for the learner. (Module 4: Take time to recharge)
5. Demonstrate compassion for PWSUD and empower co-workers to do the same. (Module 5: Empathize and empower)

References

Module 1 

·         National Institute on Drug Abuse. Words Matter: Preferred Language for Talking About Addiction. Addiction Science. Published June 3, 2021. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction(opens in a new tab)

·         Andrea Perez. Substance Use Stigma Assessment and Response (SSAR). Marion County Public Health Department; 2023

·         Shatterproof. Ending addiction stigma. Published 2023. https://www.shatterproof.org/our-work/ending-addiction-stigma(opens in a new tab)

·         National Association of Addiction Treatment Providers. The Science Behind Addiction. https://www.naatp.org/addiction-treatment-resources/understanding-addiction#:%7E:text=As%20a%20chronic%20and%20relapsing%20brain%20disorder%2C%20addiction,consequences.%E2%80%9D%20Addiction%20Is%20Not%20a%20Lack%20of%20Willpower(opens in a new tab)

·         Substance Abuse and Mental Health Services Administration. Harm Reduction. https://www.samhsa.gov/find-help/harm-reduction#:%7E:text=Harm%20reduction%20services%20save%20lives%20by(opens in a new tab)

·         Bazazi AR, Zaller ND, Fu JJ, Rich JD. Preventing opiate overdose deaths: examining objections to take-home naloxone. J Health Care Poor Underserved. 2010;21(4):1108-1113. doi:10.1353/hpu.2010.0935

·         Jones JD, Campbell A, Metz VE, Comer SD. No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone. AddictBehav. 2017;71:104-106. doi:10.1016/j.addbeh.2017.03.008

·         Link BG, Phelan JC. Conceptualizing Stigma. Annu Rev Sociol. 2001;27(1):363-385. doi:10.1146/annurev.soc.27.1.363

·         John Hopkins Medicine. What we say and do matters to patients with substance use disorder. Reducing the Stigma of Addiction. Published 2023. https://www.hopkinsmedicine.org/stigma-of-addiction/(opens in a new tab)

·         Psych Hub. Substance Use: Stop the Stigma.; 2021. https://www.youtube.com/watch?v=7xiUb0gLTG0(opens in a new tab)

·         DISRUPTING STIGMA: How Understanding, Empathy, and Connection Can Improve Outcomes for Families Affected by Substance Use and Mental Disorders. National Center on Substance Abuse and Child Welfare https://ncsacw.acf.hhs.gov/files/disrupting-stigma-brief.pdf(opens in a new tab)

·         National Institute on Drug Abuse. Stigma and Addiction. Published June 2022. https://nida.nih.gov/research-topics/stigma-discrimination#stigma(opens in a new tab)

·         Ethical Imperatives to Overcome Stigma Against People With Substance Use Disorders. AMA J Ethics. 2020;22(8):E702-708. doi:10.1001/amajethics.2020.70

·         Aronowitz S, Meisel ZF. Addressing Stigma to Provide Quality Care to People Who Use Drugs. JAMA Netw Open. 2022;5(2):e2146980. doi:10.1001/jamanetworkopen.2021.46980

·         Biancarelli DL, Biello KB, Childs E, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019;198:80-86. doi:10.1016/j.drugalcdep.2019.01.037

Module 2

·       District of Columbia Office of Disability Rights. Person First Language. Published 2023. https://odr.dc.gov/page/people-first-language

·       DISRUPTING STIGMA: How Understanding, Empathy, and Connection Can Improve Outcomes for Families Affected by Substance Use and Mental Disorders. National Center on Substance Abuse and Child Welfare https://ncsacw.acf.hhs.gov/files/disrupting-stigma-brief.pdf(opens in a new tab)

·       Shatterproof. Words Matter | Shatterproof; 2021. https://youtu.be/5QX17g6Xuk0(opens in a new tab)

·       Elizabeth Brico. The words we use shape the way we define ourselves and the world around us. Reducing Drug Addiction Stigma Through Language. Published November 29, 2018. https://www.workithealth.com/blog/reducing-addiction-stigma-through-language/(opens in a new tab)

·       National Institute on Drug Abuse. Words Matter - Terms to Use and Avoid When Talking About Addiction. Health Professions Education. Published November 29, 2021. https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction

Module 3

·       U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/social-determinants-health(opens in a new tab)

·       U.S. Department of Health and Human Services. 5 Social Determinants of Health in Healthy People 2030.; 2022. https://www.youtube.com/watch?v=2UK7NrHOsmA(opens in a new tab)

·       Substance Abuse and Mental Health Services Administration. Harm Reduction. Published April 24, 2023. https://www.samhsa.gov/find-help/harm-reduction(opens in a new tab)

·       Substance Abuse and Mental Health Services Administration. How to Help Someone You Care About. Find Support. Published April 24, 2023. https://www.samhsa.gov/find-support/helping-someone

Module 4

·       Almansa-Sáez AM, Carmona-Samper ME, Merchán-Carrillo AM, Fernández-Medina IM. Level of professional quality of life and coping with death competence in healthcare professionals exposed to perinatal loss: A cross-sectional study. Death Stud. Published online March 28, 2023:1-10. doi:10.1080/07481187.2023.2193811

·       Ondrejková N, Halamová J. Prevalence of compassion fatigue among helping professions and relationship to compassion for others, self-compassion and self-criticism. Health Soc Care Community. 2022;30(5):1680-1694. doi:10.1111/hsc.13741

·       Coderre-Ball A, Maisonneuve F, Grady C, et al. Exploring How Organizations Can Support Psychological Self-care and Protect its Workers From Moral Distress. In: Healthcare Services, Delivery, and Financing. American Academy of Family Physicians; 2023:3563. doi:10.1370/afm.21.s1.3563

·       Dalgaard VL, Gayed A, Hansen AKL, et al. A study protocol outlining the development and evaluation of a training program for frontline managers on leading well-being and the psychosocial work environment in Danish hospital settings – a cluster randomized waitlist controlled trial. BMC Public Health. 2023;23(1):848. doi:10.1186/s12889-023-15728-2

·       Bhandari S. Compassion Fatigue: Symptoms to Look For. WebMD. Published. https://www.webmd.com/mental-health/signs-compassion-fatigue(opens in a new tab). Published November 17, 2020.

·       U.S. Department of Health and Human Services. Surgeon General's Advisory Addressing Health Worker Burnout. https://youtu.be/Ak2RNYZwiP4(opens in a new tab) Published May 25, 2022.

·       Stamm, B.H.  (2016, January). Comprehensive Bibliography of Documents Specifically Using the ProQOL Measure. The Center for Victims of Torture. www.proqol.org(opens in a new tab)

·       NASDAQ OMX’s News Release Distribution Channel. Chicago Mental Health Experts Outline 7 Ways to Attain Balance for Improved Mental Health Throughout the Holiday Season: Compass Health Center offers seven ways to improve mental health this season. https://compasshealthcenter.net/in-the-media/(opens in a new tab) Published October 27, 2022.

·       Health & Medicine Week. Diet and Nutrition - Nutrition Therapy; Findings from Harvard School of Medicine Broaden Understanding of Nutrition Therapy (Adjunctive Nutrition Therapy for Depression). Published March 22, 2019. https://www.proquest.com/wire-feeds/diet-nutrition-therapy-findings-harvard-school/docview/2194159401/se-2(opens in a new tab)

·       Nazaribadie M, Ghaleiha A, Ahmadpanah M, et al. Effectiveness of Mindfulness Intervention on Cognitive Functions: A Meta-analysis of Mindfulness Studies. Propósitos Represent. 2021;9(SPE3). doi:10.20511/pyr2021.v9nSPE3.1200

·       Wong HJ, White KM. A theory-based examination of self-care behaviours among psychologists. Clin Psychol Psychother. 2021;28(4):950-968. doi:10.1002/cpp.2550

·       National Institute of Mental Health. National Institute of Mental Health. Caring for Your Mental Health. Published 2021. https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health(opens in a new tab)

·       National Institute of Mental Health. Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider. https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider(opens in a new tab)

·       J Marks. The Best Grounding Techniques for Anxiety Relief. Psych Central. Published. Published October 8, 2021. https://psychcentral.com/anxiety/using-the-five-senses-for-anxiety-relief#grounding-exercises-for-anxiety(opens in a new tab)

·       The Couch: A Therapy & Mental Wellness Blog. Anxiety 5, 4, 3, 2, 1 – A Simple Grounding Technique for Anxiety. Published October 29, 2020. https://blog.zencare.co/anxiety-5-4-3-2-1/#:~:text=The%20Anxiety%205%2C%204%2C%203%2C%202%2C%201%20technique

 Module 5

·       Leite Ferreira V, Gonçalves de Andrade Tostes J, Knaak S, Silveira PS da, Fernandes Martins L, Mota Ronzani T. Attitudes of health professionals towards people with substance use disorders in Brazil, controlling for the effects of social desirability. Health Soc Care Community. 2022;30(5). doi:10.1111/hsc.13749

·       Selseng LB, Follevåg BM, Aaslund H. How People with Lived Experiences of Substance Use Understand and Experience User Involvement in Substance Use Care: A Synthesis of Qualitative Studies. Int J Environ Res Public Health. 2021;18(19):10219. doi:10.3390/ijerph181910219

·       Lorenzetti V, Gaillard A, Beyer E, et al. Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence. BMC Psychiatry. 2023;23(1):407. doi:10.1186/s12888-023-04789-7

·       Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health. 2013;28(3-4):194-205. doi:10.1080/19371918.2013.759005

·       April Messer. Nurses’ experiences caring for patients with opioid use disorders. Univ N C Greensb. Published online December 1, 2022. https://libres.uncg.edu/ir/uncg/listing.aspx?id=38641

·       MD Scalco. Moderators and Mediators of the Effect of Early Substance Use on Later Substance Use Disorder: Can Developmental and Neuropsychological Theories of Substance Use and Substance Use Disorder be Integrated? State Univ N Y Buffalo. Published online 2017. https://www.proquest.com/dissertations-theses/moderators-mediators-effect-early-substance-use/docview/1980860067/se-2

·       Agency for Healthcare Research and Quality. Why Improve Patient Experience? The CAHPS Ambulatory Care Improvement Guide. https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/2-why-improve/index.html#:~:text=Patients%20with%20better%20care%20experiences%20often%20have%20better%20health%20outcomes.&text=For%20example%2C%20studies%20of%20patients,outcomes%20a%20year%20after%20discharge.

·       March of Dimes. Beyond Labels: Substance Use Disorder Stigma Stories.; 2020. https://beyondlabels.marchofdimes.org/substance-use/ Beyond Labels: Substance Use Disorder Stigma Stories - YouTube

·       Ted A James, MD, MHCM. Building Empathy into the Structure of Health Care. Trends in Medicine. Published January 12, 2023. https://postgraduateeducation.hms.harvard.edu/trends-medicine/building-empathy-structure-health-care#:~:text=Studies%20demonstrate%20how%20empathy%20improves,they%20feel%20heard%20and%20understood.

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