A Systematic Review of Interventions to Reduce Clinician Stigma Toward Individuals With Opioid Use Disorder.

BACKGROUND

Despite declines in opioid overdose deaths, stigma toward individuals with opioid use disorder (OUD) among clinicians remains a critical barrier to high-quality care. Stigma compromises therapeutic relationships, discourages care-seeking, and negatively affects clinical decision-making. This review aimed to: (1) identify clinician groups targeted by stigma-reduction interventions; (2) describe stigma measurement tools used; and (3) examine the types and effectiveness of interventions designed to reduce OUD-related stigma.

METHODS

A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and CINAHL were searched for studies published between 2020 and 2025. Studies were included if they evaluated interventions explicitly aimed at reducing stigma toward individuals with OUD among U.S. clinicians or trainees. Study quality was assessed using the Johns Hopkins Nursing Evidence-Based Practice guidelines.

RESULTS

Nineteen studies met inclusion criteria, predominantly single-group pretest-posttest designs, with sample sizes ranging from 5 to 1842 participants. Thirteen studies targeted students or trainees, while 6 focused on practicing clinicians. Interventions were categorized as didactic, contact-based, or experiential. Didactic interventions produced modest improvements in attitudes, particularly among students, but were less effective for practicing clinicians. Contact-based interventions, involving exposure to individuals with lived experience, were generally more effective among students, with mixed results among clinicians. Experiential interventions, including simulation, virtual reality, and supervised clinical experiences, consistently reduced stigma across student and clinician populations.

CONCLUSIONS

Experiential and contact-based interventions appear most effective for reducing stigma toward individuals with OUD, particularly among practicing clinicians. Future research should prioritize practicing clinicians, employ theory-informed designs, standardize stigma measures, and evaluate long-term and scalable effects to optimize stigma reduction in healthcare settings.