Experiences of opioid-related stigma among sexual assault survivors who use opioids in the community.

Opioid use is highly stigmatized, yet little is known about how stigma is experienced by community participants who are actively using opioids. Method This qualitative study explored opioid-related stigma among adults who use opioids (N = 17) and have experienced sexual violence, recruited through community outreach and local partnerships. Semi-structured interviews examined experiences of structural, interpersonal, and internalized stigma, and transcripts were analyzed using thematic analysis. Results Five themes emerged regarding opioid use and stigma: (1) pervasive judgment and rejection from family, friends, and colleagues, (2) stigmatizing encounters within healthcare and treatment systems, (3) internalized stigma and cycles of shame, (4) structural barriers that reinforce marginalization, and (5) strategies to resist and counter stigma. Conclusion Findings highlight the multifaceted nature of opioid-related stigma and its role in shaping opioid use, treatment engagement, and recovery trajectories. By centering the voices of individuals actively using non-medical opioids this study underscores the need for stigma reduction interventions that integrate harm reduction, trauma-informed care, and structural reforms.