The stigma of alcohol-related liver disease and its impact on healthcare

Journal article


Schomerus, G., Leonhard, A., Manthey, J., Morris, J., Neufeld, Maria, Kilian, C., Speerforck, Sven, Winkler, P. and Corrigan, Patrick W. (2022). The stigma of alcohol-related liver disease and its impact on healthcare. Journal of Hepatology. https://doi.org/10.1016/j.jhep.2022.04.026
AuthorsSchomerus, G., Leonhard, A., Manthey, J., Morris, J., Neufeld, Maria, Kilian, C., Speerforck, Sven, Winkler, P. and Corrigan, Patrick W.
AbstractPeople with alcohol related liver disease (ALD) experience stigma and discrimination. This review summarizes the evidence on ALD stigma in healthcare and its implications for people with ALD, drawing from the literature on mental illness stigma and specifically the stigma of alcohol use disorder (AUD). Public stigma, self-stigma and structural stigma all contribute to increased illness burden of ALD, failure or delay of seeking help, inferior healthcare, and negative health outcomes. Stigma can be experienced, but also anticipated and avoided, which all negatively impacts ALD healthcare. Blaming people with ALD for their condition is central to ALD stigma. Stigma affects ALD healthcare at all stages, from prevention, early detection and intervention, to allocation of scarce resources in liver transplantation. People with lived experience need to be empowered to lead action against the stigma of ALD. Promulgating a dynamic model of individual and social responsibility for AUD, a continuum model of harmful alcohol use, and establishing training on ALD related stigma for healthcare professionals are strategies to address stigma. Integrating addiction and ALD services, providing stigma-free prevention, and overcoming the frequent separation of addiction services from general healthcare are necessary. Beyond healthcare, addressing social inequality, the social dimensions of ALD risk and outcomes, and ensuring equal access to services is necessary to improve outcomes for all people with ALD. More research is needed on the stigma of ALD in low and middle income countries and in countries with restrictive drinking norms. Interventions to reduce ALD stigma and facilitate early help-seeking need to be developed and evaluated. Clinical trial number N.a.
Year2022
JournalJournal of Hepatology
PublisherElsevier
ISSN01688278
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jhep.2022.04.026
Publication dates
Print05 May 2022
Publication process dates
Accepted21 Apr 2022
Deposited23 May 2022
Accepted author manuscript
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File Access Level
Open
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