A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings

Abstract Background In 2019, the state of Maryland passed legislation requiring local detention centers to offer medications for opioid use disorder (MOUD) to all incarcerated individuals who met criteria for opioid use disorder (OUD). Four years later, many facilities remain out of compliance. Beyo...

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Main Authors: Katherine J. McLean, Nathan E. Kruis, Eric Weintraub, Heather Fitzsimons, Christopher Welsh, Natalie Spicyn, Brook Kearley, William Altekruse, Nicholas Rowland, Annabelle Belcher
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01291-z
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author Katherine J. McLean
Nathan E. Kruis
Eric Weintraub
Heather Fitzsimons
Christopher Welsh
Natalie Spicyn
Brook Kearley
William Altekruse
Nicholas Rowland
Annabelle Belcher
author_facet Katherine J. McLean
Nathan E. Kruis
Eric Weintraub
Heather Fitzsimons
Christopher Welsh
Natalie Spicyn
Brook Kearley
William Altekruse
Nicholas Rowland
Annabelle Belcher
author_sort Katherine J. McLean
collection DOAJ
description Abstract Background In 2019, the state of Maryland passed legislation requiring local detention centers to offer medications for opioid use disorder (MOUD) to all incarcerated individuals who met criteria for opioid use disorder (OUD). Four years later, many facilities remain out of compliance. Beyond issues of staffing, funding, and technical support, stigma may represent a barrier to MOUD implementation. Methods Using surveys and interviews among correctional professionals working in Maryland, the current exploratory study sought to identify barriers to MOUD implementation, including measures of provider-based stigma of OUD and support for MOUD. Results Quantitative and qualitative results revealed moderately high levels of OUD-related stigma and negative attitudes toward MOUD, with multivariable modeling revealing a statistically significant relationship between provider-based stigma of OUD and support for MOUD in correctional settings. Conclusion These findings suggest that stigma may be a significant barrier to MOUD implementation in local detention centers, even in the presence of legal mandates. Further, these results reveal the need for educational and anti-stigma campaigns targeted at correctional professionals who are charged with implementing policies that may contradict their previous learning or correctional training.
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series Harm Reduction Journal
spelling doaj-art-f03ae7c637c04be18fdd67c0281a3c632025-08-20T03:47:07ZengBMCHarm Reduction Journal1477-75172025-08-0122111410.1186/s12954-025-01291-zA mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settingsKatherine J. McLean0Nathan E. Kruis1Eric Weintraub2Heather Fitzsimons3Christopher Welsh4Natalie Spicyn5Brook Kearley6William Altekruse7Nicholas Rowland8Annabelle Belcher9Penn State Greater AlleghenyPenn State AltoonaUniversity of Maryland School of MedicineUniversity of Maryland School of MedicineUniversity of Maryland School of MedicineUniversity of Maryland School of MedicineUniversity of Maryland School of Social WorkUniversity of Maryland School of Social WorkPenn State AltoonaUniversity of Maryland School of MedicineAbstract Background In 2019, the state of Maryland passed legislation requiring local detention centers to offer medications for opioid use disorder (MOUD) to all incarcerated individuals who met criteria for opioid use disorder (OUD). Four years later, many facilities remain out of compliance. Beyond issues of staffing, funding, and technical support, stigma may represent a barrier to MOUD implementation. Methods Using surveys and interviews among correctional professionals working in Maryland, the current exploratory study sought to identify barriers to MOUD implementation, including measures of provider-based stigma of OUD and support for MOUD. Results Quantitative and qualitative results revealed moderately high levels of OUD-related stigma and negative attitudes toward MOUD, with multivariable modeling revealing a statistically significant relationship between provider-based stigma of OUD and support for MOUD in correctional settings. Conclusion These findings suggest that stigma may be a significant barrier to MOUD implementation in local detention centers, even in the presence of legal mandates. Further, these results reveal the need for educational and anti-stigma campaigns targeted at correctional professionals who are charged with implementing policies that may contradict their previous learning or correctional training.https://doi.org/10.1186/s12954-025-01291-zOpioid use disorder (OUD)Medications for opioid use disorder (MOUD)CorrectionsTreatmentStigma
spellingShingle Katherine J. McLean
Nathan E. Kruis
Eric Weintraub
Heather Fitzsimons
Christopher Welsh
Natalie Spicyn
Brook Kearley
William Altekruse
Nicholas Rowland
Annabelle Belcher
A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
Harm Reduction Journal
Opioid use disorder (OUD)
Medications for opioid use disorder (MOUD)
Corrections
Treatment
Stigma
title A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
title_full A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
title_fullStr A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
title_full_unstemmed A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
title_short A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings
title_sort mixed method exploratory assessment of provider based stigma of opioid use disorder oud and support for medications for opioid use disorder moud in carceral settings
topic Opioid use disorder (OUD)
Medications for opioid use disorder (MOUD)
Corrections
Treatment
Stigma
url https://doi.org/10.1186/s12954-025-01291-z
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