“A huge, unwieldy barrier to push through on a daily basis”: The effects of stigma on AOD workers and workplaces

Abstract

Background

Stigma is known to impact the experiences of people who use drugs, hampering the realisation of better health and social justice outcomes, but much less is understood about how it impacts people who work in alcohol and other drug (AOD) services.

Methods

Within an online survey, Australian AOD workers provided text responses to questions about their perceptions and experiences of stigma, job satisfaction, and workplace wellbeing (n = 190). Data were analysed using iterative categorisation, and themes outlining two stigma manifestations and one intervention were generated with reference to the Health Stigma and Discrimination Framework.

Findings

AOD workers observed and were affected by stigma directed at people who use substances, whether personally as individuals with living/lived experience or indirectly through their professional role. Identifying and addressing stigma comprised essential but under-acknowledged work, best performed in a supportive organisational context. Contending with the structural drivers of stigma, which reinforce negative perceptions of service users and limit the effectiveness of health and wellbeing interventions, was described as both stressful and motivating. Workers also derived a sense of moral responsibility and experienced pride or personal fulfillment in providing compassionate care and contributing to progressive social change.

Conclusions

Understanding, responding to, and mitigating stigma need recognition as core aspects of AOD professional roles. To support worker retention and wellbeing, we suggest AOD services prioritise the development of strategies for working within a stigmatised context, while continuing to advocate against the injustices that stigma creates for people who use drugs.