Multi-Level Intervention to Reduce Stigma of SUD and CL Involvement

Stigma related to substance use and criminal-legal (CL) involvement hinders an individual's access to evidence-based addiction treatment. Stigma manifests at the structural, social, and personal levels and requires multi-level interventions to address it effectively. In a study published in Health and Justice, researchers conducted a non-randomized effectiveness trial of a multi-level stigma intervention called Combatting Stigma to Aid Reentry and Recovery (CSTARR). The study included 46 CL staff and 66 CL-involved individuals in six Tennessee counties who were engaged with the incarceration diversion program Tennessee Recovery Oriented Compliance Strategy (TN-ROCS). CSTARR is designed to tackle stigma related to substance use and criminal-legal involvement by enhancing staff's attitudes and behaviors toward clients and improving clients' self-efficacy and engagement with mandated substance use treatment. The study uses various scales to evaluate the staff's and clients’ stigma and the effectiveness of the interventions that aim to improve treatment outcomes and reduce stigma in criminal-legal and substance use contexts. Authors note that the study is the first to evaluate a stigma intervention designed for a criminal-legal setting, and the results can be used to inform a larger, randomized controlled trial.