The role of genetic explanations of substance use disorders in shaping stigma in the general public.

BACKGROUND

Substance use disorders (SUDs) are among the most highly stigmatized mental health conditions, with stigma acting as a key barrier to treatment engagement and recovery. SUDs are especially stigmatized as they are more likely to be viewed as voluntary conditions, compared to other mental health illnesses. As genetic research increasingly illuminates the biological underpinnings of addiction, it is important to know whether this understanding reduces or reinforces stigma in the general public.

SUMMARY: We conducted a review to identify studies examining the relationship between genetic explanations of SUDs and stigmatizing attitudes. Across both correlational and experimental studies, genetic attributions consistently reduced personal blame toward individuals with SUDs. This finding is consistent with attribution theory, which states that individuals will be blamed less if their condition is viewed as outside of their control. Effects on other dimensions of stigma, including perceptions of dangerousness, fear, and desire for social distance, were inconsistent across studies. Studies were limited by the use of deterministic, binary genetic framings that do not accurately reflect the complex interplay of genetic and environmental factors underlying addiction risk.

KEY MESSAGES: Genetic attributions consistently reduced personal blame toward individuals with SUDs, while associations with other stigma-related attitudes wereless clear. Within the disease-model framework, reduced blame is interpreted as a reduction in stigma-related attitudes, although frameworks emphasizing individual agency may interpret this finding differently. Future research should adopt scientifically accurate gene-environment frameworks and re-evaluate the effect on stigma, attend to the needs of individuals with lived experience of addiction, and examine how changes in interpersonal stigma interact with structural stigma. Careful communication of genetic findings is essential to avoid reinforcing essentialist views of addiction.