Self-stigma in Opioid Use Disorder: The roles of depression, hopelessness, anxiety, stress, and resilience

Abstract

Background: Self-stigma is a critical challenge for individuals with opioid use disorder (OUD), exacerbating negative self-perceptions and hindering recovery efforts. While previous studies have examined the effects of depression, anxiety, and stress in OUD populations, limited research has explored the complex interplay between self-stigma, hopelessness, and resilience. This study aimed to examine the relationships between self-stigma, depression, anxiety, stress, hopelessness, and resilience in individuals diagnosed with OUD. Methods: A total of 399 individuals diagnosed with OUD participated in the study at Ankara Training and Research Hospital's Alcohol and Substance Addiction Treatment Center. Participants completed validated self-report measures, including the Depression, Anxiety, and Stress Scale (DASS-21), Beck Hopelessness Scale (BHS), Connor-Davidson Resilience Scale (CDRS-SF), and the Substance Abuse Self-Stigma Scale (SASSS). A hierarchical multiple regression analysis was conducted to determine the predictive roles of resilience, hopelessness, depression, anxiety, and stress on self-stigma. Results: Resilience was negatively correlated with self- stigma (r =-0.28, p < .001) but not predictive. Depression ((3 = .39, p < .001) and hopelessness ((3 = .12, p < .01) were significant predictors of self-stigma, whereas anxiety and stress did not emerge as significant predictors in the final regression model. Conclusions: Depression and hopelessness play key roles in the internalization of stigma among individuals with OUD, underscoring the need for targeted mental health interventions. Future studies should focus on longitudinal research designs and explore the effectiveness of interventions aimed at reducing depression and hopelessness while enhancing resilience to mitigate self-stigma in OUD populations.