Abstract

Background: Substance use related problems including smoking and alcohol use are among the leading preventable risk factors for premature death. However, people with these problems did not get the treatment they need. Stigma against substance use could be the potential barrier for people with problematic substance use to seek professional help. Therefore, the objective of this study was to investigate the magnitude and associated factors of perceived stigma towards problematic substance use.

Method: A total of 2400 participants were screened using the Cut down, Annoyed, Guilty, and Eye-opener (CAGE) Adapted to Include Drugs (CAGE-AID) questionnaire. We found 540 participants screened positive for problematic substance use (alcohol, hashish, tobacco and khat) and interviewed them for perceived stigma using Perceived Stigma of Substance Abuse Scale (PSSAS).  Logistic regression was used to examine associated factors with perceived stigma.

Result: Three hundred forty-five (63.9%) participants reported perceived stigma above the mean value of Perceived Stigma of Substance Abuse Scale (PSSAS). Variables positively associated with perceived stigma were lower wealth (AOR = 1.70, 95% CI = 1.09, 2.65) and joblessness (AOR = 4.92, 95% CI = 3.19, 7.60), history of separation from family members before age of 18 years (AOR = 2.00, 95% CI = 1.27, 3.16), poly substance misuse (AOR = 2.04, 95% CI = 1.29, 3.24) and awareness about economic crisis of substance use (AOR = 2.29, 95% CI = 1.43, 3.66).

Conclusion and recommendation: Approximately 3 in 5 people with problematic substance use perceived as they have been stigmatized by others. Health planning for problematic substance use should focus on stigma reduction.

Keywords: Perceived stigma, Problematic Substances use, Urban, Ethiopia, Low-income