Successful alcohol, drug recovery hampered by discrimination

November 26, 2019

BOSTON - Even after resolving a problem with alcohol and other drugs, adults in recovery report experiencing both minor or "micro" forms of discrimination such as personal slights, and major or "macro" discrimination such as violation of their personal rights. These experiences are associated with increased distress and lead to both diminished quality of life and a decrease in resources needed to successfully sustain recovery, investigators from the Recovery Research Institute and Center for Addiction Medicine at Massachusetts General Hospital (MGH) and Harvard Medical School (HMS) report.

The findings, which have important implications for both substance use disorder treatment and public policy, are published in the journal Drug and Alcohol Dependence.

Although previous studies of persons with substance use disorder found evidence of discrimination while symptomatic, or when incarcerated, or in other stigmatized situations, this is believed to be the first study to look at the prevalence and types of discrimination experienced among those who report that they have resolved a problem and are in recovery, says lead author Corrie L. Vilsaint, PhD, a research fellow at MGH.

She and her colleagues surveyed a nationally representative sample of 2,002 US adults who reported resolving an alcohol or other drug problem and asked, "Since resolving your problem with alcohol or drugs, how frequently have the following occurred because someone knew about your alcohol or drug history?"

The questions solicited information about micro discrimination such as "people assumed I was likely to relapse" and "people said I looked like an alcoholic or addict" and macro discrimination such as job loss, denial of a loan or housing, denial of the right to vote, or insurance refusals.

"In general, we found that nearly 50 percent of the people said that others 'assumed I would relapse', and 38 percent said they felt like at times they were being held to a higher standard than other people. We also captured that about 18 percent reported that they felt like they had been treated unfairly by the police," she says.

In addition 16.2 percent of respondents said they were denied employment, 7.7 percent said they were denied the right to vote, 15.2 percent said that it was hard for them to get medical insurance, 11.2 percent said that insurance would not cover some of their medical costs, and 9.4percent said that they were denied housing, all because someone knew of their prior history of alcohol or other drug problems.

After adjusting for the severity of addiction and years since resolution of the problem, the investigators found that respondents who reported greater levels of discrimination were significantly more likely to suffer from higher psychological distress, lower quality of life, and decreased "recovery capital" - the sum total of resources needed for successful recovery.

"These findings have social and policy implications" Vilsaint says. "It is tough enough struggling with the physical and psychological demands of recovery without having to contend with the kinds of discrimination reported fairly frequently here. Some of these residual tolls that you see in these people's lives from past drug history or past criminal history related to their drug use can block them from seeking addiction recovery, block them from seeking treatment and block them from disclosing that they need help."

The investigators note that additional study is needed to determine which discriminatory experiences are most likely to have a negative effect on recovery efforts.
-end-
Co-authors of the paper in Drug and Alcohol Dependence are Lauren A. Hoffman, PhD, and John F. Kelly, PhD, from the MGH Recovery Research Institute.

The study was funded by the MGH Recovery Research Institute. Vilsaint's and Kelly's work is supported by awards from the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, and Hoffman's work is supported by an award from the NIH National Institute on Drug Abuse. The authors declared no conflicts of interest.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $1 billion and comprises more than 8,500 researchers working across more than 30 institutes, centers and departments. In August 2019 the MGH was once again named #2 in the nation by U.S. News & World Report in its list of "America's Best Hospitals."

Massachusetts General Hospital

Related Alcohol Articles from Brightsurf:

Alcohol use changed right after COVID-19 lockdown
One in four adults reported a change in alcohol use almost immediately after stay-at-home orders were issued: 14% reported drinking more alcohol and reported higher levels of stress and anxiety than those who did not drink and those whose use stayed the same.

Changes in hospitalizations for alcohol use disorder in US
Changes over nearly two decades in the rate of hospitalizations and in-hospital deaths from alcohol use disorder in the US were examined in this study.

Associations of alcohol consumption, alcohol-induced passing out with risk of dementia
The risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers was examined in this observational study with more than 131,000 adults.

New alcohol genes uncovered
Do you have what is known as problematic alcohol use?

Does estrogen influence alcohol use disorder?
A new study from researchers at the University of Illinois at Chicago shows that high estrogen levels may make alcohol more rewarding to female mice.

Sobering new data on drinking and driving: 15% of US alcohol-related motor vehicle fatalities involve alcohol under the legal limit
A new study in the American Journal of Preventive Medicine, published by Elsevier, found that motor vehicle crashes involving drivers with blood alcohol concentrations (BACs) below the legal limit of 0.08 percent accounted for 15% of alcohol-involved crash deaths in the United States.

Alcohol-induced deaths in US
National vital statistics data from 2000 to 2016 were used to examine how rates of alcohol-induced deaths (defined as those deaths due to alcohol consumption that could be avoided if alcohol weren't involved) have changed in the US and to compare the results by demographic groups including sex, race/ethnicity, age, socioeconomic status and geographic location.

Cuts in alcohol duty linked to 2000 more alcohol-related deaths in England
Government cuts to alcohol taxes have had dramatic consequences for public health, including nearly 2000 more alcohol-related deaths in England since 2012, according to new research from the University of Sheffield's School of Health and Related Research (ScHARR).

Integrated stepped alcohol treatment for people in HIV care improves both HIV & alcohol outcomes
Increasing the intensity of treatment for alcohol use disorder (AUD) over time improves alcohol-related outcomes among people with HIV, according to new clinical research supported by the National Institutes of Health.

The Lancet:Targets to reduce harmful alcohol use are likely to be missed as global alcohol intake increases
Increasing rates of alcohol use suggest that the world is not on track to achieve targets against harmful alcohol use, according to a study of 189 countries' alcohol intake between 1990-2017 and estimated intake up to 2030, published in The Lancet.

Read More: Alcohol News and Alcohol Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.