In a 2025 national study, more than 30% of providers said they prefer not to work with patients with OUD; versus 2% for diabetes and 9% for HIV or depression.
(Parish et al., 2025, Addiction)
Emergency medicine providers showed the highest stigma toward substance use of any group studied. Important as these are the professionals often at the first, and sometimes only, point of care.
(Parish et al., 2025, Addiction)
Frontline responders face a specific risk: compassion fatigue and burnout from repeated overdose calls, which can harden into stigma.
(Emergency personnel study, 2022; Morssy & Kavanaugh, 2026)
People with opioid use disorder wait an average of 4–7 years between onset and treatment, and fewer than 35% receive treatment in a given year.
Nationally, nearly 60% of people with addiction report experiencing stigma from a healthcare provider.
Where staff show compassion, patients' fear of being judged drops and they are more likely to stay in care.
(ED staff compassion study, 2024)
The Power of the First Interaction
The first interaction someone has with a provider, nurse, or intake coordinator can shape whether they come back for care or avoid it altogether. More than 30% of providers say they'd prefer not to work with patients who have opioid use disorder, compared to 2% for diabetes — not because providers are unkind, but because most clinical training simply hasn't covered how to approach OUD the way it covers other chronic conditions. Research has found when staff shows compassion, patients describe feeling less afraid of judgment and are more likely to stay in care.
Treat opioid use disorder the way you'd treat any chronic disease
- Apply the same care standards as diabetes or hypertension
- Focus on symptom management and long-term care, not a one-time fix
- Assess symptoms, pain, and needs the way you would for any patient — a history of opioid use doesn't change the standard of care
Take Our Free 15-Minute Training
Our 15-minute on-demand training offers an overview of stigma, how it appears and what you can do.
Share this training with all staff and providers.
Practical Steps Providers Can Take
You don’t need to overhaul your practice to make a difference.
A few evidence-based approaches go a long way.
Show you care before you show what you know.
Treat every patient with dignity at every step. From the first greeting to the exam room, and everywhere in between.
Don’t turn people away.
People asking for help are already vulnerable and full of shame. Being rejected confirms that shame and makes them less likely to ask again.
Lead with compassion, even when it’s busy.
In fast-paced places like the emergency department, one caring interaction can be a turning point. Walking through the door took courage.
Ask what they need instead of assuming.
Treat patients as the experts on their own lives. Help guide their solutions rather than imposing yours.
Listen reflectively.
Pay attention, validate their experience, and repeat back what they said in their own words so they feel heard.
Use person-first language.
Drop labels like “addict” that reduce someone to one identity. They’re a son, daughter, mother or sister who deserve respect. Learn more about person-first language.
Never stop offering hope.
Recovery may take a few attempts but never give up on the person.
Remember you could be a patient’s lifeline.
If you give up on a patient, they may give up on themselves. Recovery is always possible.
Screen and refer, don’t confront
- Screen all patients for substance use with validated tools (AUDIT, DAST-10)
- Use motivational interviewing rather than confrontational approaches
- Offer warm handoffs to addiction specialists when needed
Manage pain without assumptions
- Build individualized pain management plans for patients with a history of addiction
- Coordinate with addiction specialists for patients on medication for OUD
- Assess pain on its own terms, rather than discounting it because of addiction history
Reducing Stigma: How to Start
Pick the level that fits your role:
On your own
- Complete addiction stigma training
- Audit your own patient communication for stigmatizing language
- Learn motivational interviewing techniques
- Partner with addiction specialists for consultation
With your team or department
- Implement universal screening protocols
- Update patient forms to use person-first language
- Train all staff — including administrative and clinical — to recognize and interrupt stigmatizing language and actions in the moment
- Establish referral relationships with treatment providers
Across your health system
- Update policy language to reflect the medical model
- Integrate addiction services into primary care
- Collect and monitor patient experience data
- Implement organization-wide stigma reduction training
Medication for Opioid Use Disorder (MAT)
Stigma can lead providers to withhold effective medications for OUD — often without realizing it.
Get the facts on MAT, common misconceptions, and how to talk with patients about treatment options.
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