Assessment of Self-Stigma in Individuals with Substance Use Disorders: An Insight from a Local Psychiatric Clinic in Harare
Authors
Psychology Department, Sally Mugabe Central Hospital (Zimbabwe)
Article Information
DOI: 10.47772/IJRISS.2026.10100464
Subject Category: Social science
Volume/Issue: 10/1 | Page No: 5963-5971
Publication Timeline
Submitted: 2026-01-25
Accepted: 2026-01-30
Published: 2026-02-13
Abstract
Substance use disorders (SUDs) results in stigmatized conditions which end up causing self-stigma in individuals with substance use disorders. It is said that, self-stigma occurs when individuals internalize societal stereotypes and negative attitudes towards oneself which is a significant psychological barrier that individuals with substance use disorders often face. The impact of self-stigma on treatment seeking, recovery and overall wellbeing of individuals with SUDs has been widely recognised. This study aimed to assess self-stigma in individual with SUDs who were being treated at a local psychiatric clinic in Harare. A descriptive simple random sampling of both sexes was done. A structured questionnaire comprising of validated measures was used to assess self-stigma adapted from Substance Abuse Self-Stigma Scale. Consent was sought verbally and in writing before collecting data. The results of this study showed that individuals with SUDs feel as burdens to their families, SUDs defines a person’s worth and limit opportunities were the major factors that led to self-stigma. Self-stigma was impacted by difficult to disclose, isolation and social withdrawal, barrier to accessing support, diminish self-worth and esteem that hindered recovery process. The findings also showed the preferred interventions by this sample population which were implementation of anti-stigma campaigns, access to accurate and non-stigmatizing information and counselling. It is anticipated that, by reducing self-stigma, treatment seeking behaviours, treatment adherence and overall well-being among individuals with SUDs can be improved.
Keywords
Self-Stigma, Substance use disorder (SUD)
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References
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 [Google Scholar] [Crossref]
2. American Society of Addiction Medicine. (2011). The definition of addiction. https://www.asam.org/Quality-Science/definition-of-addiction [Google Scholar] [Crossref]
3. Bandura, A. (1999). A social cognitive theory of personality. In L. Pervin & O. John (Eds.), Handbook of personality: Theory and research (2nd ed., pp. 154-196). New York: Guilford Press. [Google Scholar] [Crossref]
4. Birtel, M. D., Wood, L., & Kempa, N. J. (2017). Stigma and social support in substance use disorder: Implications for mental health and well-being. Psychiatry Research, 252, 1–8. https://doi.org/10.1016/j.psychres.2017.01.097 [Google Scholar] [Crossref]
5. Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625. https://doi.org/10.1037/0003-066X.59.7.614 [Google Scholar] [Crossref]
6. Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35-53. [Google Scholar] [Crossref]
7. Corrigan, P. W., Morris, S. B., Michaels, P. J., et al., (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963-973. [Google Scholar] [Crossref]
8. Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25(8), 875-884. [Google Scholar] [Crossref]
9. Crapanzano K.A, Hammarlund R., Ahmad B., et al., (2019). The association between perceived stigma and substance use disorder treatment outcomes: Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311321/. [Google Scholar] [Crossref]
10. Daley D.C., (2013) Family and social aspects of substance use disorders and treatment. J Food Drug Anal. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158844/. [Google Scholar] [Crossref]
11. Elkalla, I. H. R., El-Gilany, A., and Baklola, M. (2023). Assessing self-stigma levels and associated factors among substance use disorders. 10.1186/s12888-023-05093-0 [Google Scholar] [Crossref]
12. Grant, B., Saha, D. F. and Ruan W. J. (2016). Epidemiology of DSM-5 drug use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions–III. [Google Scholar] [Crossref]
13. Gureje, O., Albidulmalik, J., and Kota, L. (2015). Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. [Google Scholar] [Crossref]
14. Hammarlund R.A., Crapanzano K. A., Luce L., Mulligan L. A., et al., (2018). Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders. [Google Scholar] [Crossref]
15. Kelly, J. F., & Yeterian, J. D. (2019). Empowering patients with addiction through shared decision-making: A roadmap for providers. Journal of Substance Abuse Treatment, 99, 80-86. [Google Scholar] [Crossref]
16. Kelly, J. F., Stout, R. L., Slaymaker, V., & Zywiak, W. H. (2015). Sampling bias in treatment research on substance use disorders: A longitudinal study of recruitment source effects. Journal of Substance Abuse Treatment, 59, 96-100. [Google Scholar] [Crossref]
17. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363-385. [Google Scholar] [Crossref]
18. Livingston, J. D., & Boyd, J. E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71(12), 2150-2161. https://doi.org/10.1016/j.socscimed.2010.09.030 [Google Scholar] [Crossref]
19. Livingston, J. D., & Boyd, J. E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71(12), 2150-2161. [Google Scholar] [Crossref]
20. Livingston, J. D., Milne, T., Fang, M. L., et al., (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction, 107(1), 39-50. https://doi.org/10.1111/j.1360-0443.2011.03601.x [Google Scholar] [Crossref]
21. Luoma, J. B., Twohig, M. P., Waltz, T., Hayes, S. C., Roget, N., Padilla, M., … Fisher, G. (2010). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviors, 35(9), 783–790. https://doi.org/10.1016/j.addbeh.2010.03.012 [Google Scholar] [Crossref]
22. Luoma, J. B., Twohig, M. P., Waltz, T., et al., (2007). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviors, 32(7), 1331-1346. [Google Scholar] [Crossref]
23. Luoma, J. B., Twohig, M. P., Waltz, et al., (2013). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviors, 38(11), 2606-2611. [Google Scholar] [Crossref]
24. Luoma, J. B., Twohig, M. P., Waltz, T., et al., (2017). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive behaviours, 71, 1-6. [Google Scholar] [Crossref]
25. Makuvaza, H. B., Makoni, J. C., & Mutsvangwa, T. E. (2019). Self-stigma and Makuvaza, H. B., Makoni, J. C., & Mutsvangwa, T. E. (2019). Self-stigma and mental health symptoms among individuals with substance use disorders in Zimbabwe. Journal of Substance Use, 24(6), 640-644. https://doi.org/10.1080/14659891.2019.1601042 [Google Scholar] [Crossref]
26. Makuvaza, H. B., Makoni, J. C., & Mutsvangwa, T. E. (2021). Self-stigma as a barrier to treatment-seeking behavior among individuals with substance use disorders in Zimbabwe. Journal of Substance Use, 26(1), 1-6. https://doi.org/10.1080/14659891.2020.1859302 [Google Scholar] [Crossref]
27. Masson, C. L. (2015). An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential. Vol.26. 11. https://doi.org/10.1016/j.drugpo.2015.04.015 [Google Scholar] [Crossref]
28. Melchior, H., Husing, P., and Grundmann, J. et al., (2018). Substance Abuse-Related Self-Stigma in Women with Substance Use Disorder and Comorbid Posttraumatic Stress Disorder. https://doi.org/10.1159/000496113 [Google Scholar] [Crossref]
29. Muswerakwekuenda, F. F. (2023). Access to psychosocial support for church-going young people recovering from drug and substance abuse in Zimbabwe: a qualitative study. BMC Public Health volume 23, Article number: 723. [Google Scholar] [Crossref]
30. Myers, B., Fakier, N., & Louw, J. (2018). Stigma, treatment beliefs, and substance abuse treatment use in South Africa: A longitudinal study. Substance Abuse Treatment, Prevention, and Policy, 13(1), 1-10. https://doi.org/10.1186/s13011-018-0153-7 [Google Scholar] [Crossref]
31. National Institute on Drug Abuse. (2020). Drug Facts: Understanding drug use and addiction. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction [Google Scholar] [Crossref]
32. National Institute on Drug Abuse. (2021). Understanding Drug Use and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction [Google Scholar] [Crossref]
33. New Zealand Ministry of Health. (2020). Structural stigma in health-care contexts for people with mental health and substance use issues [Google Scholar] [Crossref]
34. Oluwole, E. O., Adegbohun, A. A., & Adeyemi, J. D. (2018). Self-stigma and its correlates among clients with substance use disorders attending a Nigerian psychiatric hospital. Journal of Substance Use, 23(3), 288–293. https://doi.org/10.1080/14659891.2017.1388728 [Google Scholar] [Crossref]
35. Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer. [Google Scholar] [Crossref]
36. Rey, G. N. (2016). Validity and Reliability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in University Students. [Google Scholar] [Crossref]
37. Stringer, K. L and Baker, E. H. (2018). Stigma as a barrier to substance abuse treatment among those with unmet need: an analysis of parenthood and marital status. Journal of family Issues. Vol.39. 1. https://doi.org/10.1177/0192513X15581659 [Google Scholar] [Crossref]
38. United Nations Office on Drugs and Crime. (2021). World drug report 2021: Executive summary. https://wdr.unodc.org/wdr2021/field/WDR21_Booklet_1_EXECUTIVE_SUMMARY.pdf [Google Scholar] [Crossref]
39. United Nations Office on Drugs and Crime. (2021). World drug report 2021: Africa. https://wdr.unodc.org/wdr2021/en/country-summaries-africa.html [Google Scholar] [Crossref]
40. Weiner, B. (2018). The legacy of an attribution approach to motivation and emotion: A no-crisis zone. A no-crisis zone. Motivation Science, 4(1), 4–14. https://doi.org/10.1037/mot0000082 [Google Scholar] [Crossref]
41. Winstanley, C. (2016). Emergency department prescription opioids as an initial exposure preceding addiction. Vol.68.2. https://doi.org/10.1016/j.annemergmed.2015.11.033 [Google Scholar] [Crossref]
42. Worl Drug Report. (2018). United Nations Office on Drugs and Crime. https://doi.org/10.1515/sirius-2018-0016 [Google Scholar] [Crossref]
43. World Health Organization. (2018). Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2016. WHO. https://www.who.int/healthinfo/global_burden_disease/estimates/en/ [Google Scholar] [Crossref]
44. World Health Organization. (2018). Global status report on alcohol and health 2018. World Health Organization. https://www.who.int/publications/i/item/9789241565639 [Google Scholar] [Crossref]
45. World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1448597234 [Google Scholar] [Crossref]
46. World Health Organization. (2018). Substance abuse. Retrieved from https://www.who.int/news-room/fact-sheets/detail/substance-abuse [Google Scholar] [Crossref]
47. World Health Organization. (2019). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. https://www.ncbi.nlm.nih.gov/books/NBK547908/ [Google Scholar] [Crossref]
48. Yang, C., Zhou,Q. and Cao, Q. (2019). The Relationship Between Self-Control and Self-Efficacy Among Patients with Substance Use Disorders: Resilience and Self-Esteem as Mediators. Vol. 10. https://doi.org/10.3389/fpsyt.2019.00388 [Google Scholar] [Crossref]
49. Zimbabwe Civil Liberties and Drug Network. (2019). A general review of Zimbabwe's response to drug and substance abuse among the youth. [Google Scholar] [Crossref]
50. Zwick, J., Appleseth, H., & Arndt, S. (2020). Stigma: how it affects the substance use disorder patient. [Google Scholar] [Crossref]
51. mental health symptoms among individuals with substance use disorders in Zimbabwe. Journal of Substance Use, 24(6), 640-644. https://doi.org/10.1080/14659891.2019.1601042 [Google Scholar] [Crossref]
52. Makuvaza, H. B., Makoni, J. C., & Mutsvangwa, T. E. (2021). Self-stigma as a barrier to treatment-seeking behavior among individuals with substance use disorders in Zimbabwe. Journal of Substance Use, 26(1), 1-6. https://doi.org/10.1080/14659891.2020.1859302 [Google Scholar] [Crossref]
53. Masson, C. L. (2015). An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential. Vol.26. 11. https://doi.org/10.1016/j.drugpo.2015.04.015 [Google Scholar] [Crossref]
54. Melchior, H., Husing, P., and Grundmann, J. et al., (2018). Substance Abuse-Related Self-Stigma in Women with Substance Use Disorder and Comorbid Posttraumatic Stress Disorder. https://doi.org/10.1159/000496113 [Google Scholar] [Crossref]
55. Muswerakwekuenda, F. F. (2023). Access to psychosocial support for church-going young people recovering from drug and substance abuse in Zimbabwe: a qualitative study. BMC Public Health volume 23, Article number: 723. [Google Scholar] [Crossref]
56. Myers, B., Fakier, N., & Louw, J. (2018). Stigma, treatment beliefs, and substance abuse treatment use in South Africa: A longitudinal study. Substance Abuse Treatment, Prevention, and Policy, 13(1), 1-10. https://doi.org/10.1186/s13011-018-0153-7 [Google Scholar] [Crossref]
57. National Institute on Drug Abuse. (2020). Drug Facts: Understanding drug use and addiction. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction [Google Scholar] [Crossref]
58. National Institute on Drug Abuse. (2021). Understanding Drug Use and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction [Google Scholar] [Crossref]
59. New Zealand Ministry of Health. (2020). Structural stigma in health-care contexts for people with mental health and substance use issues [Google Scholar] [Crossref]
60. Oluwole, E. O., Adegbohun, A. A., & Adeyemi, J. D. (2018). Self-stigma and its correlates among clients with substance use disorders attending a Nigerian psychiatric hospital. Journal of Substance Use, 23(3), 288–293. https://doi.org/10.1080/14659891.2017.1388728 [Google Scholar] [Crossref]
61. Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer. [Google Scholar] [Crossref]
62. Rey, G. N. (2016). Validity and Reliability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in University Students. [Google Scholar] [Crossref]
63. Stringer, K. L and Baker, E. H. (2018). Stigma as a barrier to substance abuse treatment among those with unmet need: an analysis of parenthood and marital status. Journal of family Issues. Vol.39. 1. https://doi.org/10.1177/0192513X15581659 [Google Scholar] [Crossref]
64. United Nations Office on Drugs and Crime. (2021). World drug report 2021: Executive summary. https://wdr.unodc.org/wdr2021/field/WDR21_Booklet_1_EXECUTIVE_SUMMARY.pdf [Google Scholar] [Crossref]
65. United Nations Office on Drugs and Crime. (2021). World drug report 2021: Africa. https://wdr.unodc.org/wdr2021/en/country-summaries-africa.html [Google Scholar] [Crossref]
66. Weiner, B. (2018). The legacy of an attribution approach to motivation and emotion: A no-crisis zone. A no-crisis zone. Motivation Science, 4(1), 4–14. https://doi.org/10.1037/mot0000082 [Google Scholar] [Crossref]
67. Winstanley, C. (2016). Emergency department prescription opioids as an initial exposure preceding addiction. Vol.68.2. https://doi.org/10.1016/j.annemergmed.2015.11.033 [Google Scholar] [Crossref]
68. Worl Drug Report. (2018). United Nations Office on Drugs and Crime. https://doi.org/10.1515/sirius-2018-0016 [Google Scholar] [Crossref]
69. World Health Organization. (2018). Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2016. WHO. https://www.who.int/healthinfo/global_burden_disease/estimates/en/ [Google Scholar] [Crossref]
70. World Health Organization. (2018). Global status report on alcohol and health 2018. World Health Organization. https://www.who.int/publications/i/item/9789241565639 [Google Scholar] [Crossref]
71. World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1448597234 [Google Scholar] [Crossref]
72. World Health Organization. (2018). Substance abuse. Retrieved from https://www.who.int/news-room/fact-sheets/detail/substance-abuse [Google Scholar] [Crossref]
73. World Health Organization. (2019). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. https://www.ncbi.nlm.nih.gov/books/NBK547908/ [Google Scholar] [Crossref]
74. Yang, C., Zhou,Q. and Cao, Q. (2019). The Relationship Between Self-Control and Self-Efficacy Among Patients with Substance Use Disorders: Resilience and Self-Esteem as Mediators. Vol. 10. https://doi.org/10.3389/fpsyt.2019.00388 [Google Scholar] [Crossref]
75. Zimbabwe Civil Liberties and Drug Network. (2019). A general review of Zimbabwe's response to drug and substance abuse among the youth. [Google Scholar] [Crossref]
76. Zwick, J., Appleseth, H., & Arndt, S. (2020). Stigma: how it affects the substance use disorder patient. [Google Scholar] [Crossref]
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