To deepen our understanding of this issue and the pathways to action in anti-stigma work, this rapid review investigated the characteristics and effectiveness of interventions aimed to reduce substance use-related stigma. It used the Action Framework for Building an Inclusive Health System to guide the identification and categorization of existing evidence for anti-stigma strategies and interventions. Furthermore, the interventions were thematically organized by type, with a description of their level of impact and effectiveness in reducing stigma among study samples.

Rapid review key findings

• The review found 36 peer-reviewed articles and 8 from grey literature meeting inclusion criteria. Published between 2019 and 2023, the studies primarily focused on the United States (24 studies), Canada (8 studies), and other OECD countries. Findings indicate the multifaceted nature of stigma intervention strategies across different levels: interpersonal/social (18 studies), institutional (16 studies), and population/structural (2 studies).
• Language interventions showed mixed outcomes, while training/skill-based programs demonstrated effectiveness, particularly those incorporating motivational interviewing and contact with individuals with lived experience of substance use. General education interventions targeting specific groups, such as librarians and faith-based communities, displayed positive effects on knowledge and attitudes. Increasing connection strategies, such as including patient panels, significantly reduced stigma.
• Policy and practice-based interventions, like addiction consultation services with traumainformed approaches, highlighted the influence of past healthcare experiences in perpetuating stigmatization cycles. Public campaigns with visual messaging and narrative vignettes contributed to decreased stigma levels among healthcare professionals. Multi-component interventions, combining training, education, and connection strategies, consistently demonstrated significant reductions in stigma across various populations.
• The review highlighted the importance of adopting an intersectional lens, considering factors like gender, occupation, concurrent stigmatized illnesses, religion, and race.
• Despite progress, challenges and gaps persist, including the limited evidence for multi-level interventions, the need for institutional support for community engagement, and the importance of authentic engagement for effective and sustained stigma reduction.