Health Care Professionals’ Attitudes Toward Patients with Substance Use Disorders Improve with Experience

This systematic review focused on studies assessing health care professionals’ attitudes toward patients with substance use disorders (SUD) and their effect on health care delivery. The authors identified 28 studies conducted in Western countries published between 2000 and 2011. Study populations included nurses, professionals from addiction and mental health institutions, and physicians. The authors’ general conclusions were:

• A high proportion of health care professionals had a negative attitude toward patients with SUD compared with other patient groups, such as those with diabetes or mental illness.
• Attitudes toward people with illicit drug use in particular were strongly negative and health care providers preferred for these patients to be cared for by addiction specialists.
• Many health care professionals reported poor knowledge of SUD and felt they lacked the education and skills to care for patients with these disorders. Training and experience in caring for populations with these disorders were associated with increasingly positive attitudes.
• Institutional support for health care providers also contributed to an increase in positive attitudes.
• Consequences of attitudes were seldom assessed. One study showed that perceived discrimination was associated with less treatment completion and another that the care provided to patients with SUD was suboptimal.

Comments:

Some studies showed positive attitudes toward patients with SUD, but in general, negative attitudes among health care providers prevailed. Training and experience were associated with more positive attitudes. Addiction medicine training and experience should be encouraged in organizations and educational institutions to improve health care providers’ confidence as well as treatment outcomes.

Nicolas Bertholet, MD, MSc

Reference:

van Boekel LC, Brouwers EP, van Weeghel J, Garretsen HF. Stigma among health professionals toward patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug Alcohol Depend. 2013;131(1–2):23–35.