Internalized Stigma, Recovery Capital, Family Support, and Social Exclusion in Individuals with Substance Use Problems Receiving Mandated Treatment Under Deferred Prosecution in Taiwan.

Abstract

Background: Social exclusion is an important but understudied aspect of recovery among individuals receiving mandated addiction treatment under deferred prosecution.

Methods: Using a cross-sectional survey of 288 participants in Taiwan (85.4% male; mean age = 41.01 years, SD = 10.09), this study tested associations of internalized stigma, recovery capital, and family support with social exclusion, and examined recovery capital as a mediator of the stigma-exclusion association.

Results: Internalized stigma was positively associated with social exclusion, while recovery capital and family support were negatively associated. In the final regression model (43.2% variance explained), recovery capital (β = -0.441, p < 0.001) and family support (β = -0.217, p < 0.001) remained independently associated with lower social exclusion, whereas internalized stigma was no longer significant (β = 0.109, p = 0.061). Recovery capital significantly mediated the stigma-exclusion association even after adjustment for family support (indirect effect = 0.41, 95% CI [0.22, 0.64]).

Conclusions: These results indicate that social exclusion in this population reflects psychosocial vulnerability, recovery-supporting resources, and relational context, and point to the importance of addressing exclusion directly in recovery and reintegration efforts.