1 - (SYM 80) A Third-wave Behavioral Intervention Targeting Self-stigma Related to Criminal Involvement and Substance Use Disorder

Many people with a substance use disorder (SUD) will experience arrest and incarceration. The intersectional stigma of addiction and criminal involvement is pervasive and makes it challenging for people with these histories to stay in recovery after release from incarceration. For example, addiction is often thought of as a choice deserving of punishment rather than treatment, and people with criminal backgrounds are viewed as dangerous and untreatable. Some treatments for addiction, such as medications for opioid use disorder, are further stigmatized and thought of as “substitute drugs.” These negative judgements weigh heavily on people with SUDs and can lead to internalized stigma, which increases risk for drug overdose and other negative outcomes. Although there are promising internalized stigma interventions for people with SUDs, they have yet to be adapted for the intersectional stigma of SUD and criminal involvement. This study presents findings from a non-randomized pilot feasibility trial of an internalized stigma intervention for people experiencing SUD and criminal involvement. Acceptance and commitment therapy for substance use stigma was integrated with dialectical behavior therapy skills and delivered to 66 adults with felony convictions enrolled in drug recovery court (52% female, 85% White, M age=40 years). Results showed significant decreases in internalized stigma (baseline M=22.6, SD=7.9, post-test M=20.4, SD= 8.0, p=.002, d=0.3) from baseline to post-intervention. In qualitative interviews, participants described the intervention with statements such as, “[I] liked how it addressed a lot of issues and thoughts I've been having about myself and my past,” and “No one seemed to judge me.” Results suggested this new intervention was acceptable and may reduce the stigma of addiction and criminal involvement among justice-involved populations.