Addictive Behaviors 34 (2009) 360–364

Contents lists available at ScienceDirect

Addictive Behaviors

Adolescent stigma towards drug addiction: Effects of age and drug use behaviour
Edward M. Adlaf a,b,c, Hayley A. Hamilton a,c,⁎, Fei Wu d, Samuel Noh a,c
a
Centre for Addiction and Mental Health, Toronto, Ontario, Canada
b
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
c
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
d
University of California, Los Angeles, California, United States

a r t i c l e i n f o a b s t r a c t

Keywords: The objective of this study was to examine adolescent age and experience with drug use on stigmatizing
Drug addiction attitudes toward drug addiction. Data were derived from the 2005 cycle of the Ontario Student Drug Use
Drug use Survey. In total, 4078, 7- to 12-graders completed self-administered questionnaires that included a measure
Stigma
of drug abuse stigma. Results indicated that stigma scores were higher among younger than older
Adolescents
adolescents, and the decline across age was robust, occurring among both males and females and those from
Personal drug use
Friend drug use rural and non-rural areas. The decline, however, was stronger among non-drug users and among those who
had no close friends that use drugs. Despite the age-related decline, the level of stigma in general suggested
that drug abuse stigma may continue into adulthood. Findings highlight that individual attitudes toward
drug use and drug abusers are salient factors for personal drug use. Given that stigma is a barrier to
treatment, but reduced stigma may encourage greater adolescent use, this study highlights the need for more
in-depth studies of drug stigma.
© 2008 Elsevier Ltd. All rights reserved.

1. Introduction
Stigma against substance abuse is often viewed as one component
of the stigmatization of psychiatric disorders, perhaps because of the
co-morbidity of substance disorders and psychiatric disorders (Kessler
et al., 1994) and/or common stereotypes of blame and dangerousness
(Link, Phelan, Bresnahan, Stueve, & Pescosolido, 1999). The nature and
intensity of public attitudes toward people with addiction disorders,
however, are found to differ from the attitudes toward those with a
mental illness (Rasinski, Woll, & Cooke, 2005; Room, 2005). Typically,
individuals who abuse drugs tend to receive more severe stigma than
those with a mental illness (Link, Struening, Rahav, Phelan, &
Nuttbrock, 1997), likely because drug abuse is not seen as a medical
condition, but considered as an act of personal choice or moral failure.
Those who abuse drugs in general are thus considered more
responsible for their condition, more dangerous (Corrigan et al.,
1999; Link et al., 1999), and are more likely to be avoided socially
(Albrecht, Walker, & Levy, 1982). Such direct avoidance and social
distance means that the stigmatized are often excluded from useful
social interactions (Link & Phelan, 2001). In general, adult community
studies report the desire for social distance or avoidance is greatest
towards individuals who abuse drugs, those who abuse alcohol, and
those persons with a mental illness, in descending order (Albrecht
⁎ Corresponding author. Centre for Addiction and Mental Health, 455 Spadina Ave.,
Suite 300, Toronto, Ontario, Canada M5S 2G8. Tel.: +1 416 535 8501x7620; fax: +1 416
979 0564.
E-mail address: hayley_hamilton@camh.net (H.A. Hamilton).
et al., 1982; Cunningham, Sobell, & Chow, 1992; Link et al., 1999).
Despite findings of increased stigma against individuals who use
substances relative to those who are mentally ill, much of the research
on stigma has focused on mental illness. This may be related to greater
acceptance of stigmatizing attitudes and behaviours toward those
who abuse drugs, for example, given policy directives to define drug
use as bad and deviant. A consequence, however, is that there is far
less research knowledge on drug stigma and its correlates, which is
problematic given that stigma is a barrier to treatment seeking and
community integration (U.S. Department of Health and Human
Services, 1999).
In addition to a scarcity of research on drug stigma, there is also
tremendous focus on adult populations. Often neglected is the
question of whether negative attitudes also hold among adolescents.
The limited number of studies that have examined negative stereo-
types held by adolescents about drug abuse indicate that individuals
who are addicted to drugs are viewed negatively overall (Dean & Rud,
1984; Plancherel et al., 2005; Power, Power, & Gibson, 1996; Zastowny,
Adams, Black, Lawton, & Wilder, 1993). These studies also indicate that
individuals who inject drugs or use heroin are viewed more negatively
than those who use cocaine (Power et al., 1996); and that regular users
of marijuana consider marijuana less dangerous relative to alcohol and
heroin than do individuals who are occasional or past users
(Plancherel et al., 2005).
Adolescence is a critical period for internalizing social values and
attitudes toward people in general and persons who are socially
stigmatized in particular (Hinshaw, 2005; Schulze, Richter-Werling,
Matschinger, & Angermeyer, 2003; Spitzer & Cameron, 1995; Wahl,

0306-4603/$ – see front matter © 2008 Elsevier Ltd. All rights reserved.
doi:10.1016/j.addbeh.2008.11.012
 E.M. Adlaf et al. / Addictive Behaviors 34 (2009) 360–364
2002). Negative attitudes formed during this period are of concern
because attitudes and behaviours from adolescence often continue
into adulthood (Secker, Armstrong, & Hill, 1999). If not modified, such
attitudes can develop into prejudices and discriminatory behaviours
with negative social consequences. A special focus on adolescence is
also important because research findings based on adult samples
cannot be simply generalized to adolescents given differences in
maturity and development (Corrigan et al., 2005). Further, adolescent
attitudes often predict their everyday behaviour (Burlew et al., 2000).
Negative attitudes toward individuals would often result in direct
avoidance and social distance, thus disqualifying or excluding the
stigmatized from meaningful and gainful social interactions (Goffman,
1963; Link & Phelan, 2001; Schur, 1971).
Research on negative attitudes among adolescents toward persons
with a mental illness suggests that negative attitudes are evident
among young children and increase with age (Wahl, 2002). Wahl's
(2002) review of the literature indicates that although the level and
accuracy of knowledge about mental illness increases from childhood
through adolescence, negative attitudes are evident in children as
young as 5 years of age and continue across developmental stages.
Such findings would suggest that negative attitudes toward drug abuse
may also increase with age. On the other hand, adolescence is often
accompanied by peer pressure and individual experiences that may
lead to the rejection of antidrug messages imparted during elementary
school. Thus, adolescents may abandon or reduce their negative
attitudes toward drug abuse (Burlew et al., 2000). Greater tolerance of
individuals who abuse drugs would reduce the desire for social
distance and reduce what Goffman (1963) refers to as “courtesy
stigma”, which reflects negative attitudes toward persons who are in
some way associated with those who abuse drugs—e.g., the children or
siblings of drug users may be perceived as members of a deviant family.
An important consideration in examining drug stigma among
adolescents is adolescents' own drug use and that of their close peers.
Drug use is known to increase during adolescence. For example, a
2007 survey of Ontario students indicates that the proportion of
students reporting past-year drug use increases across each grade in
middle and high school (Adlaf & Paglia-Boak, 2007). U.S. data for 2004
indicate that the proportion of students reporting that they ever used
marijuana is more than twice as great among 10th-graders than 8th-
graders, and the proportion reporting that they have used marijuana
in the past month is approximately three times greater (Johnston,
O'Malley, & Bachman, 2005). This suggests that maintaining stereo-
types and stigmatizing attitudes toward those who abuse drugs may
be difficult when individuals themselves use drugs or have relation-
ships with persons who do. As such, negative attitudes toward, and
the desire for social distance from, persons who abuse drugs might be
influenced by individuals' level of experience or contact with those
who use drugs. A study of 14 to 22 year olds who use marijuana
(current users, past users, and occasional/non-users) found that their
beliefs about marijuana use differed according to their own use
(Plancherel et al., 2005). Current users considered marijuana to be less
dangerous and both current and past users were less likely to consider
it an illegal drug and more likely to consider its use as a way of
relieving stress. In contrast, non-users/occasional users had more
negative attitudes toward marijuana use.
The main objective of this study is to examine the association
between adolescent age and stigma towards individuals addicted to
drugs. Primary questions of interest are: Do negative attitudes toward
drug addiction decrease with age such that stigma is greater in early
adolescence when there is often less familiarity with drug use and
greater abidance to the ‘drugs are bad’ message conveyed in earlier
childhood? Is the association curvilinear such that there is some
similarity in negative attitudes in early and late adolescence, with
greater tolerance in late middle and early high school periods? Do
negative attitudes vary with characteristics of the individual adoles-
cent perceiver—e.g., is a person's own use of drugs and association with
361
peers who use drugs associated with negative attitudes toward drug
addiction and the desire for social distance? The role of adolescent sex
and community context are also considered in assessing the influence
of age on negative attitudes toward drug addiction.
2. Methods
2.1. Sample
We analyze data based on self-administered questionnaires from
4078 7th- to 12th-graders (ages 12 to 19 years), derived from the 2005
cycle of the Ontario Student Drug Use Survey (OSDUS), a province-
wide survey of Ontario students (Adlaf & Paglia-Boak, 2005). The
OSDUS, conducted every odd year since 1977, is funded by the Centre
for Addiction and Mental Health (CAMH) and is the longest ongoing
school study of adolescents in Canada. The survey employs a two-
stage cluster design (school, class) and monitors substance use,
mental health, physical health, gambling, and delinquent behaviour
among students. The sample represents students in regular public and
Catholic schools, and thus excludes about 7 % of students in alternate
schools. The 2005 cycle was based on a total sample of 7726 students
in grades 7 to 12, from 42 school boards, 137 schools, and 445
classrooms. The stigma items, however, were asked of a random half
sample of 4078 students only. Students completed self-completed
questionnaires in intact classrooms. The school and student comple-
tion rates were 94% and 72%, respectively. Reasons for non-completion
included absenteeism (12%) and absence of active parental consent
(16%). CAMH's Research Ethics Board approved this study. Further
details regarding the study and questionnaire are available at: http://
www.camh.net/research/population_life_course.html.
2.2. Measures
Stigma towards drug addiction was assessed using four social
distance items modified from the World Psychiatric Association's
Schizophrenia Open the Door project (World Psychiatric Association,
1999). The items were: (1) Would you be afraid to talk to someone
who is addicted to drugs? (2) Would you be upset or disturbed to be in
the same class with someone who is addicted to drugs? (3) Would you
make friends with someone who is addicted to drugs? (4) Would you
feel embarrassed or ashamed if your friends knew that someone in
your family was addicted to drugs? Original responses were based on
a 5-point scale (definitely, probably, probably not, definitely not, not
sure). Prior to summation, we recoded the “not sure” category to the
midpoint. Not only do we feel confident that the category is an
indication of neutrality in this case, we replicated our analysis
excluding the "not sure" responders and found no substantive
differences in the results. Items 1, 2, and 4 were reverse-coded such
that higher scores indicate greater stigma. Responses to the four items
were averaged to form a composite drug stigma scale with a
Cronbach's alpha of .76.
Illicit drug use was defined by a three category dummy variable
indicating whether the adolescent respondent reported the use of 11
drugs at least once during the 12-month period preceding the survey.
The three dummy variables were cannabis use only; the use of other
drugs (heroin, barbiturates, methamphetamine, LSD, PCP, other
hallucinogens, cocaine, crack, nonmedical stimulants, and non-
prescription tranquillizers); and non-use of the listed drugs.
Use of drugs by respondents' peers was assessed by a question
asking the proportion of close friends who use marijuana or hashish.
Responses were collapsed into three categories: none, some, and
about half or more.
Additional variables included in analyses were age, biological sex,
and urbanicity. Age ranged from 12 to 19 years. Female respondents
were coded as 1. Residence in an urban or rural setting was derived
from the student's postal code, with rural coded as 1.
362 E.M. Adlaf et al. / Addictive Behaviors 34 (2009) 360–364

2.3. Data analysis Table 2

Unstandardized regression coefficients and robust estimates of standard errors of the
predictors of drug stigma
All analyses were weighted to account for the unequal probabilities
of selection, and all variance and statistical tests employed Taylor Predictors Model 1 Model 2 Model 3 Model 4 Model 5
series methods to account for the complex survey sample design Agea −.172⁎⁎⁎ −.130⁎⁎⁎ −.075⁎⁎⁎ −.075⁎⁎⁎ − .132⁎⁎⁎
(StataCorp, 2003). Ordinary least squares regression was used to (.011) (.011) (.011) (.011) (.019)
Age squared .042⁎⁎⁎ .039⁎⁎⁎ .029⁎⁎⁎ .030⁎⁎⁎ .015⁎
examine the relationship between age, sex, urbanicity (rural resi-
(.006) (.006) (.006) (.006) (.006)
dence), individual and peer drug use, and drug stigma. Both linear and Sex (female = 1) .034 .026 .021 .017 .025
quadratic age terms were included in the models for a possible (.036) (.035) (.034) (.034) (.033)
nonlinear effect of age on drug stigma. Four two-way interactions Urbanicity (rural = 1) −.093 −.064 −.041 −.034 − .036
between age variables and sex, urbanicity, individual drug use, and (.051) (.044) (.049) (.045) (.046)
Personal drug useb
friends who use drugs were included in regression models to examine
Cannabis use only −.364⁎⁎⁎ −.039 − .138⁎
the possibility of moderating effects. Age variables were centered in (.047) (.049) (.060)
order to reduce the correlation between the linear and quadratic Other drug use −.826⁎⁎⁎ – .470⁎⁎⁎ − .488⁎⁎⁎
terms and interaction terms (Aiken & West, 1991). (.050) (.057) (.065)
Friends' drug usec
Some friends −.579⁎⁎⁎ −.535⁎⁎⁎ − .507⁎⁎⁎
3. Results (.044) (.047) (.049)
Half or more of friends −.951⁎⁎⁎ −.786⁎⁎⁎ − .810⁎⁎⁎
3.1. Sample characteristics (.050) (.058) (.067)
Interactions
Age × cannabis use .080⁎
Basic demographic data and drug use behaviour are outlined in
(.034)
Table 1. Respondents from urban areas constitute 84.9% of the sample. Age × other drug use .041
Additionally, 27.9% used one of 11 illicit drugs in the past year, and 56% (.034)
had friends who used marijuana or hashish. Responses to items that Age × some friends .093⁎⁎
form the drug stigma scale indicate that over half of students (53.9%) (.030)
Age × half or more friends .099⁎
would “definitely” or “probably” feel ashamed if their friends knew (.041)
that someone in their family was addicted to drugs. About one-third of Constant 2.743 2.908 3.199 3.21 3.21
students reported being afraid to talk with a drug abuser (31.3%) or R2 .124 .199 .247 .265 .275
make friends with a drug abuser (31.2%), and about one in five (22.9%) *p b .05; **p b .01; ***p b .001; N = 3937.
reported that they would be upset or disturbed to be in the same class a
Age is centered at the mean.
b
with someone addicted to drugs. Reference category is no drug use.
c
Reference category is none (no friends use marijuana or hashish).

3.2. Drug stigma and age

The regression results in Table 2 show the effect of age on drug
stigma. In the first model both linear and quadratic age terms show
significant associations with drug stigma. The coefficients suggest an
inverse and curvilinear association between age and negative attitudes
toward individuals who are addicted to drugs. This first model also
indicates no effects of sex and rural residence on negative attitudes.
Models 2 through 4 indicate the association between drug stigma
and adolescents' familiarity with drug use. Compared to non-users,
adolescents who have used illicit drugs indicate significantly less
stigmatizing attitudes toward drug addiction (model 2). In addition,
adolescents who have used cannabis in the past year report more
stigmatizing attitudes than adolescents who have used other drugs (F
(1,129) = 73.37, p b .001). Results in model 3 reveal a negative associa-
tion between stigma and the proportion of close friends who use
marijuana or hashish. Adolescents who report that half or more of
their friends use drugs report less stigmatizing attitudes than those
with fewer friends who use drugs (F(1,129) = 74.30, p b .001).
The influence of friends' drug use is much greater than that of
adolescents' own drug use. This is evident from the increase in
variance explained in model 1 (R2 = .124) to those shown in model 2 for
own drug use (R2 = .199) and model 3 for peer use (R2 = .247). Further,
adjustments for both individual and peer drug use in model 4 result in
a 89% decline in the coefficient for individual cannabis use to
nonsignificance and a 43% decline in the coefficient for other drug
use. In contrast, only small changes are evident in the coefficients for
peer drug use across models. As well, the inclusion of personal drug
use accounts for 24.4% of the effect of age on stigma (−.172 vs. −.130),
while the inclusion of peer drug use accounts for 56.4% (−.172
vs. −.075). However, as shown in model 4, the age–stigma association
is still significant even after sex, urbanicity, and the two measures of
drug use are taken into account.
To examine the extent to which the age–stigma association varies
across categories of sex, urbanicity, and drug use, two-way interaction

Table 1
Descriptive statistics

Variable Mean/percentage
Drug stigma 2.9 (sd = .98)
Age 14.9 (sd = 1.87)
Female 48.7%
Rural setting 15.1%
Drug use in past 12 months
Cannabis only 16.1%
Other drugs 11.8%
None 72.1%
Friends who use drugs
Some friends 32.7%
Half or more of friends 23.3%
None 44.0%
Fig. 1. Mean stigma across age by personal drug use.
 E.M. Adlaf et al. / Addictive Behaviors 34 (2009) 360–364
Fig. 2. Mean stigma across age by number of close friends using drugs.
terms were included in separate models. Neither sex nor urbanicity
significantly moderate the age–stigma association. However, both
adolescent's own drug use and peer drug use significantly moderate
the relationship between age and drug stigma (model 5). Differences
in the relationship between age and drug stigma by individual drug
use are illustrated in Fig. 1. It is evident from the graph that drug
stigma is much higher among younger adolescents who do not use
drugs than among those who have used illicit drugs; however, this
difference between users and non-users decreases at higher ages. This
decreased difference is particularly evident between non-users and
individuals who have used cannabis, such that those who use cannabis
in later adolescence match and then exceed the level of stigma
reported by non-users. Among adolescents who have used other
drugs, in contrast, differences with non-drug users in reports of
stigma remain relatively similar at young and older adolescent ages.
There is some indication, however, of a rise in drug stigma during the
later adolescent years among adolescents who have used illicit drugs.
The moderating effect of peer drug use on the association between
age and drug stigma is shown in Fig. 2. Those adolescents whose
friends do not use drugs report higher stigma against drug addicts,
compared with those with drug-using friends; however, the level of
stigma declined significantly between younger and older ages. Having
drug-using friends is associated with lower stigma throughout
adolescence. Among adolescents with drug-using friends stigma
declines in early adolescence and shows some increase in late
adolescence.
Three-way interactions were examined for possible variations of
the moderating effects of drug use and peer drug use on stigma.
Results showed that the moderating effects reported in model 5 were
consistent for male and female adolescents and for those attending
urban and rural schools.
4. Discussion
The results displayed a clear decline in drug stigma across age
during much of adolescence. This trend was robust, and observed in
both males and females, as well as among adolescents in urban and
rural schools. The data also suggest a developmental trend of unifying
values and attitudes concerning drug addiction among adolescents.
There are two bases for this claim. First, the effects of the age-by-sex
and age-by-rural residence interactions were negligible, suggesting
that the increased tolerance of drug addiction across much of
adolescence occurs regardless of sex and urban/rural location. Second,
neither sex nor rural residence conditioned the moderating effects of
adolescent drug use and peer use of marijuana or hashish. These
results confirm that the age–stigma association is quite independent
363
of sex and residence. Indeed, we found little relevance of sex or the
location of the school.
What factors contribute to the decline in stigma across adoles-
cence? Results suggest that individual drug use and close association
with friends who use drugs are important factors in this decline.
Stigma against individuals who are addicted to drugs is inversely
related to adolescents' own drug use and the prevalence of drug use
(specifically marijuana and hashish) among close friends. This finding
is consistent with earlier research findings that youth's beliefs about
marijuana use differed according to their own use (Plancherel et al.,
2005). Although causal direction cannot be determined from the
present study, it is evident that familiarity or contact with drug using
friends is indeed related to a reduction in stigma, especially among
those in early- to mid-adolescence. Study findings further highlight
the moderating effects of individual and peer drug use, with the
greatest decline in stigma occurring among adolescents who have
never used drugs and who have no friends who use drugs.
The type of drug used by adolescents was also found to be
important. Negative attitudes toward drug addiction were more
severe among adolescents who use cannabis than among adolescents
who use other illicit drugs. This may be somewhat attributed to a
perception among individuals who use only cannabis that their
behaviour is less dangerous and their drug of choice less addictive.
Thus, they may see little similarity between themselves and persons
who are addicted to drugs. Adolescents who use other forms of illicit
drugs may differentiate between themselves and others to a lesser
degree resulting in less negative attitudes and desire for social
distance.
Although individual and peer drug use explain some of the age–
stigma association, a large proportion of the association remains
unexplained. Perhaps the most critical aspect of stigma against drug
addiction is the potential positive consequences that may be attained
through social control (Ahern, Stuber, & Galea, 2007; Room, 2005).
Indeed, a key feature of many drug use prevention programs is having
individuals, especially children and youth, distance themselves from
persons who use drugs. Our finding regarding the declines in negative
attitudes among non-users might be a reflection of this early, but
temporary influence. The transition into middle and high school may
create experiences and pressures that lead individuals to relinquish
the antidrug messages and deviant connotations related to drug abuse
and addiction. The similarity in negative attitudes between non-users
and users of cannabis by late adolescence was brought about by a
rapid decline in stigma among non-drug use adolescents. Thus, the
data show some homogenization in attitudes toward drug addiction
between those who do not use drugs and those who use cannabis
only.
It is important to note that although there are indications of a
decline in stigma, there is also evidence of a curvilinear relationship
between age and stigma. The decline in stigma tapers off in late
adolescence among non-users and in mid to late adolescence for
users. There is evidence, however, of rising stigma among older
adolescents who use drugs, particularly users of cannabis. Thus, even
drug-using respondents seem to express a degree of social distance in
late adolescence. Potential reasons for increases in negative attitudes
at this age are varied and may include greater awareness of the
broader consequences of addiction and consequently even greater
separation between personal drug use and attitudes. These findings
suggest a need for further research on a broader age range of youth
and young adults to determine if the decline in stigma towards
individuals who are addicted to drugs is simply a function of
adolescent experiences. Research utilizing longitudinal data would
also be better able to detect age-related changes in drug stigma and
relate such changes to developmental and life stage experiences.
This study expands the research on adolescents' negative attitudes
toward drug addiction by reporting data derived from a large
representative sample of adolescents. But, the study is not without
364 E.M. Adlaf et al. / Addictive Behaviors 34 (2009) 360–364
limitations. We are cognizant of the possibility of not fully capturing
the concept of stigma with the four items used in this study. The items
capture social distance to a greater extent than overall stigma. Despite
this shortcoming, the measure is a good one given our focus on the
shifting nature of negative attitudes toward individuals addicted to
drugs across stages of adolescence. The items used, however, may
explain the lack of significant differences between male and female
adolescents. The items used are more reflective of attitudes rather
than discriminatory behaviour. Research on the stigma of mental
illness indicates that females and males are similar in negative
attitudes; however, females are less likely to support discriminatory
behaviour and are more accepting of individuals with mental illness
(Farina, 1981, 1998). Another limitation is the use of a composite
measure of stigma. There may be significant variation in adolescents'
attitudes depending on the circumstances or nature of their interac-
tion with individuals who are addicted to drugs. For example, courtesy
stigma may be less of an issue in that they are less likely to shun
persons who have family members that are addicted to drugs,
whereas becoming friends with someone who is addicted may be
perceived as more problematic. The data are also limited by self-
report, given that important variables, namely stigma towards drug
addiction, personal drug use, and association with friends who use
drugs, are based on classroom-administered questionnaires. Indivi-
duals may be less likely to report behaviour that they themselves
perceive as socially undesirable and that may be considered deviant
within the larger society. An additional limitation is that findings with
regard to peer drug use are limited to peers who use marijuana or
hashish as information on the use of other illicit drugs could not be
included in the analyses. Finally, it is important to note that this study
focused on stigma towards individuals who are addicted to drugs in
general. As such, it cannot address differences in stigma that may be
evident towards individuals who use drugs vs. those who abuse or are
addicted to drugs; or differences in stigma towards those addicted to
methamphetamine vs. those addicted to heroin. These are important
areas for further research.
In conclusion, this study shows that one's attitude towards drugs is
a salient factor for personal use of illicit drugs. In the case of
psychiatric disorders, most would agree that anti-stigma interven-
tions are unlikely to bring about harm, and various parties are likely to
benefit from the minimization of social distance. Moreover, personal
attitude towards mental illness and the mentally ill should not affect
the odds of developing psychiatric disorders. On the contrary, with
regard to drug stigma, it is not clear whether reducing stigma through
planned interventions would actually result in an increase in drug use
among younger adolescents. We are not aware of empirical research
evaluating the effects of intervention programs on the reduction of
stigma and changes in drug use in early adolescence. There is
evidence, however, that stigma against individuals who are addicted
to drugs is a major barrier to treatment seeking, community
integration, and, thus, public health (U.S. Department of Health and
Human Services, 1999). Thus, there is a need for more independent
investigations of drug related stigma among children and youth
(Hinshaw, 2005; Wahl, 2002) with careful consideration to the effect
that reduced stigma could have on individual drug use.
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