Beyond a Spoiled Identity: Destigmatization Through Everyday Interactions in Heroin-Assisted Treatment

• In Event: Non-Criminal Justice Responses to Delinquency Panel 2

Abstract

Stigmatization is a defining experience for people with opioid use disorder (OUD), shaping their identity and social interactions. While research on destigmatization often focuses on changing public attitudes toward people with OUD, less attention has been given to how internalized self-stigma may be reduced. Shifting focus from structural interventions aimed at mitigating external stigma to the micro-level dynamics of social interaction, this study examines how patient-provider interactions in heroin-assisted treatment (HAT) may facilitate identity reconstruction and destigmatization. Drawing on 60 in-depth interviews with 31 HAT patients, the analysis identifies three recurring interactional processes with destigmatizing potential: ordinary conversations, where patients engage in informal, non-medicalized exchanges; unburdened disclosures, where they share sensitive information without fear of judgment; and relational recognition, where their personal experiences are acknowledged in ways that affirm non-stigmatized aspects of their identity. These processes unfold in the context of frequent, structured encounters within a patient-centered framework, allowing for trust-based, non-coercive engagement between patients and healthcare providers. By illustrating how everyday social interactions can challenge the reinforcement of stigmatized identities, this study contributes to the understanding of how harm reduction services may not only provide medical support but also foster interactional conditions conducive to destigmatization.

Author

• Vegard Haukland, Department for Criminology and Sociology of Law, University of Oslo; Section for Clinical Addiction Research, Oslo University Hospital.