Removing Structural Stigma Barriers in Substance Use Disorders: Dast-10-R Introduction and Feasibility of Use

Abstract

Purpose: This quality improvement project aimed to foster transformative learning (TL) and increase knowledge regarding the use of non-stigmatizing terminology use in substance use disorder (SUD), introduce the drug abuse screening test-10-revised (DAST-10-R), and measure its feasibility for use in screening, brief intervention, and referral to treatment (SBIRT) protocols at a federally qualified health clinic (FQHC). Background: SUD is a chronic, treatable condition. People with SUD must first be identified as having the problem; then, effective treatment can be provided. There is a call to action for removing stigma barriers to effectively identify and treat the growing number of people with SUD, as the US faces the highest number of opioid related overdose deaths in history. Methods: This DNP project used a pre-post survey design as a method for measuring attitudes in TL, knowledge gained on non-stigmatizing terminology use in SUD, and feasibility of using the DAST-10-R screening tool in practice. Pre/post-intervention groups were compared on Likert and knowledge-based survey items. Likert items measured attitude; knowledge-based items measured knowledge gains. Groups were compared on Likert-type ratings using Mann-Whitney U tests for median and interquartile ranges and compared on their respective proportions of correct answers for each knowledge question using either Chi-square analysis or Fisher’s Exact Test for frequency and percentiles. Significance was assumed at an alpha value of 0.05, and analyses were performed using SPSS Version 29. Results: There were 14 behavioral health leadership team participants from the FQHC. All participants completed the pre-survey, and 10 completed the post-survey. There was evidence for transformative learning and knowledge gains on recommended terms to use in SUD. The DAST-10-R scored high rates for the feasibility of use in clinical practice. Conclusions: Education is effective for fostering transformative learning to remove structural stigma terminology in SUD realms, and the DAST-10-R is feasible for use in clinical behavioral health SBIRT protocols.