Exploring Scottish addiction services - provider-based stigma, addiction aetiology beliefs, treatment bias, and burnout among addiction treatment providers

Q: What is provider-based stigma (PBS) in this study?

PBS refers to stigma held by addiction treatment providers, measured using variants such as dangerousness, blame, social distance, and fatalism.

Q: How was the study conducted?

The study used a cross-sectional online survey completed by 64 addiction treatment providers currently working in Scotland, using validated or adapted measures and extensive statistical analyses.

Q: What relationships did PBS show with treatment approaches and burnout?

Elevated PBS variants dangerousness and blame predicted higher acceptance of abstinence-based treatments and lower endorsement of harm reduction approaches; burnout was also high, and a PBS variant (blame) predicted higher client-related burnout.

Sep 30, 2026

Uploaded by CatatanPagi

Drug-related deaths continue to rise in Scotland, alongside persistent barriers to addiction treatment shaped by stigma, burnout, and differing beliefs among treatment providers. This cross-sectional online survey of 64 addiction treatment providers assessed provider-based stigma variants (dangerousness, blame, social distance, fatalism) and examined links with burnout, job satisfaction, treatment attitudes, and addiction aetiology beliefs. Provider-based stigma predicted treatment bias, burnout, and acceptance of abstinence versus harm reduction approaches.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Introduction

Context in Scotland

Diversity of addiction services

Need to reduce stigma and treatment bias

Ciesluk etal. Substance Abuse Treatment, Prevention, and Policy (2026) 21:3 [https://doi.org/10.1186/s13011-026-00701-0](https://doi.org/10.1186/s13011-026-00701-0) Substance Abuse Treatment, Prevention, and Policy RESEARCH Open Access Exploring Scottish addiction services: provider-based stigma, addiction aetiology beliefs, treatment bias, and burnout among addiction treatment providers Beata Ciesluk1, Greig Inglis1, Adrian Parke1 and Lucy J. Troup 1,2* Abstract Background Drug related deaths continue to increase in Scotland. Many barriers to addiction treatment exist and are often related to poor provider-client relationships possibly caused by stigma, burnout and differentiating beliefs and attitudes among addiction treatment providers. This study investigated the prevalence of provider-based stigma (PBS) including four stigma variants (dangerousness, blame, social distance, fatalism) and its relationship to burnout, job satisfaction, attitudes towards addiction treatment approaches, and beliefs regarding addiction aetiology in a sample of addiction treatment providers. Methods Cross-sectional online survey was completed by 64 addiction treatment providers currently working in Scotland. Online survey was comprised of validated and adapted measures, extensive statistical analysis was conducted, including ANOVAs and Regressions to examine the outcomes of interest. Results Over 30% of participants had elevated scores on PBS variants dangerousness and blame and these were found to predict higher acceptance of abstinence-based treatments, and lower endorsement of harm reduction approaches (dangerousness: b = 0 .41, p < 0. 001; blame: b = 0 . 23, p = 0 . 010) . Burnout was high in this sample, and PBS variant blame predicted higher client-related burnout (b = 7 . 35, p = 0 . 009) . Moreover, the belief in the disease model predicted higher acceptance of abstinence-based treatments (b = 0 . 30, p < 0. 001), whereas belief in the psychosocial model predicted higher acceptance of harm reduction-based treatments (b = -0 . 25, p = 0 . 008) . Lastly belief in the disease model predicted higher scores on dangerousness (b = 0 . 19, p = 0 . 016) and fatalism (b = 0 . 29, p = 0 . 002) PBS variants. Conclusions The findings from this study provide insights for policy and addiction treatment improvements. Efforts to alleviate addiction treatment providers stigmatising attitudes, especially perceptions of people who use drugs as dangerous, blameworthy, and incapable of recovery are needed. Interventions and policy improvements need to include stigma reduction workshops and consider addiction treatment providers attitudes and beliefs to limit treatment bias, stigma and burnout to foster better relationships between clients and the workers who support them. *Correspondence: Lucy J. Troup [l.troup@norwichuni.ac.uk](l.troup@norwichuni.ac.uk) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Ciesluk et al. Substance Abuse Treatment, Prevention, an

FAQs

What is provider-based stigma (PBS) in this study?

PBS refers to stigma held by addiction treatment providers, measured using variants such as dangerousness, blame, social distance, and fatalism.

How was the study conducted?

The study used a cross-sectional online survey completed by 64 addiction treatment providers currently working in Scotland, using validated or adapted measures and extensive statistical analyses.

What relationships did PBS show with treatment approaches and burnout?

Elevated PBS variants dangerousness and blame predicted higher acceptance of abstinence-based treatments and lower endorsement of harm reduction approaches; burnout was also high, and a PBS variant (blame) predicted higher client-related burnout.

Sep 30, 2026

Uploaded by CatatanPagi