BACKGROUND: Experiencing stigma/discrimination is common in individuals who use substances. However, those with caring responsibilities for individuals who use substances may also be stigmatised and discriminated against (known as affiliate, or courtesy stigma, or stigma-by-association). Comparatively little research has examined the experiences of those who may experience courtesy stigma.

METHODS: We conducted an online survey recruiting individuals who were seeking/ receiving treatment for substance use (N = 175); individuals who have caregiving responsibility for somebody seeking or receiving treatment for substance use (N = 248); and a demographically matched comparison group (N = 363). All participants completed measures of everyday discrimination experiences as well as the perceived source and cause for discrimination, and a measure of wellbeing (WHO-5).

RESULTS: Individuals seeking/receiving treatment for substance use, as well as individuals with caregiving responsibilities reported higher levels of everyday discrimination vs the comparator group, when adjusting for socio-demographic factors. 40.7% of individuals with caregiving responsibilities reported their caring role as a cause of discrimination, and 52.5% of individuals seeking/receiving substance use reported this as a reason for discrimination. The main source of discrimination was from family and friends. Everyday discrimination had an indirect negative impact on subjective wellbeing in individuals who use substances and caregivers.

CONCLUSION: Courtesy stigma is commonly reported in caregivers to those who seek treatment for substance use, which may have negative consequences. A greater focus on those with caregiver responsibilities may positively benefit these individuals and the care they provide.