Derefinko Studying Methods to Reduce Stigma Among African Americans Seeking Treatment for Opioid Use Disorder

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Karen Derefinko, PhD, assistant professor in the Department of Preventive Medicine and the Department of Pharmacology, Addiction Science, and Toxicology at the University of Tennessee Health Science Center (UTHSC), has received a $201,631 grant to study ways to reduce the stigma those in the African American community face when seeking treatment for opioid use disorder.

Karen Derefinko, PhD

The grant from the National Center for Complementary and Integrative Health/ National Institutes of Health will fund her study titled, “Behavioral Economics based stigma reduction intervention for low income African American individuals with Opioid Use Disorder.”

“In our pilot work, we noticed that we have very few African American treatment seekers at our Center for Addiction Science,” Dr. Derefinko said. She said the UTHSC Center for Addiction Science has historically seen more Caucasian patients than African American patients seeking help at a rate of 4 to 1. However, opioid use disorder and other forms of substance abuse tend to be the same across different ethnic and racial groups.

According to Dr. Derefinko, since Memphis is an African American majority city and about 53% of Memphis residents live in medically underserved areas, shortages in health care providers are most evident in low-income, African American communities. This unequal representation in treatment highlights the barriers to care faced by many African American residents of Shelby County.

Dr. Derefinko said that her intervention focuses on decisions about behavior which are motivated by evaluations of costs and benefits. “Some costs to substance use disorder treatment seeking are clear, like the inability to pay for services and transportation, but even when we remedy that barrier, disparities remain,” she said. “Other costs to the individual are less evident, like being evaluated unfairly by your peers, family, providers, and community. For African Americans, substance use stigma is amplified because of race. That is what we’re hoping to address with this grant.”

Dr. Derefinko’s study aims to develop a multipronged approach to reduce the stigma for opioid use disorder treatment seeking by working with individual participants on reducing internalized stigma and addressing barriers to care; reducing stigma at the family and support system level; and reducing stigma at the community level by engaging with the Frayser community through a billboard campaign and partnering with community leaders, including Rev. Charlie Caswell, director of Legacy of Legends.

“Stigma is multisystemic, and so our intervention needed to be as well,” Dr. Derefinko said. “We target not only on stigma reduction across levels, but whether these interventions lead to an uptick in individuals from Frayser presenting for treatment. If we get the results we’re hoping for, we can roll this out for the whole city.”

Dr. Derefinko is very proud of the focus of UTHSC on treating the community in which it resides. “There is a university-wide effort to focus on our communities in need and the broader community in Shelby County, and I’m excited to have NIH support for our efforts.”