Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot266710.32687/0869-866X-2026-34-s1-448-452Научная статьяSTIGMATIZATION OF PATIENTS WITH SUBSTANCE USE DISORDERS AS A RISK FACTOR IN PSYCHO-NARCOLOGICAL CAREKugaevskayaT. S. Mingazova E. N.N. A. Semashko National Research Institute of Public Health 105064 Moscow RussiaKazan State Medical University 420012 Kazan Russia270620263444845229062026Copyright © 1970,1970The relevance of the topic is determined by data from numerous studies indicating a significantly higher prevalence of stigma toward individuals using psychoactive substances compared to patients with other mental disorders. Stigma is recognized as a key problem in modern healthcare systems and is defined as a systemic factor shaping the entire ecosystem of narcological care. It frequently affects the professional activities of mid-level medical personnel manifesting at interconnected levels and forming a vicious cycle that deteriorates treatment quality and outcomes while undermining the health of the staff themselves. Stereotypical and negative perceptions of patients with addictions among mid-level medical personnel lead to discriminatory care practices: ignoring pain complaints unfounded suspicions and the use of derogatory language in communication and documentation. It is stigmatizing treatment that inflicts the most severe psychological trauma becoming the primary barrier to seeking help again. Intra-organizational stigma directly contributes to adverse clinical outcomes increased relapses and mortality. 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