Notice Number: NOT-DA-25-029
Deadline: January 8, 2027
Purpose
People who use drugs experience stigma from different sources and in a variety of contexts, all of which are associated with negative outcomes. Some common stigmatizing beliefs directed toward people who use drugs include the notion that drug use is a personal choice, that people with substance use disorders (SUD) can stop using drugs if they have enough willpower, and that people with SUD are dishonest and immoral. These beliefs can manifest through negative interactions with friends and family members as well as through unpleasant encounters with healthcare providers. Stigma also exists at the structural level, such as through public policies that criminalize people with SUD. People who use drugs may also experience self-stigma, which occurs when they internalize stereotypes associated with substance use and direct these beliefs toward themselves. As a result, they often opt to not disclose to other people that they have SUD.
Stigma directed toward people who use drugs has been linked to many negative outcomes, including increases in drug use; a lower likelihood of obtaining and completing SUD treatment, including reluctance to utilizing medications for opioid use disorder or premature discontinuation of these effective medications; housing instability; criminal-legal involvement; social isolation; physical and mental health challenges; and challenges with managing acute and chronic pain among people who use drugs. The numerous negative outcomes associated with stigma highlight the need for rigorous research on ways to address stigma and its associated consequences. Therefore, this NOSI highlights support for research to develop, adapt, and/or test strategies aimed at addressing stigma at the individual, interpersonal, and/or structural levels.
Types of stigma that are of interest for this NOSI include but are not limited to:
- Structural-level stigma, such as policies that criminalize drug use and prohibit individuals who have SUD and/or take methadone from obtaining public housing; punitive responses to substance use and SUD among pregnant and parenting people; negative drug test requirements for obtaining and maintaining employment; inadequate provider reimbursement; and omission of medications for opioid use disorder (MOUD) from formularies.
- Interpersonal-level stigma, such as stigma from friends, family members, coworkers, supervisors, law enforcement officers, and healthcare providers. Healthcare providers may include doctors, nurses, medical assistants, administrative staff, pharmacists, emergency medical responders, and physical and behavioral health treatment providers who are philosophically opposed to prescribing MOUD or providing harm reduction services for people with SUD.
- Individual-level stigma, including self-stigma and internalized stigma.
Applicants are encouraged to examine how these strategies and interventions not only address stigma, but also impact the negative consequences of stigma.
For more information, please see the opportunity website.