OBJECTIVE: Recovery from severe mental illnesses (SMI) has been described as an outcome (end state where persons are symptom free) or as a process (despite symptoms, people can pursue life goals). Less clear is whether recovery as a process has credibility in the substance use disorders (SUD) community. We examined how public perceptions and expectations of outcome and process between SMI and SUD differed. A severity effect within SMI and SUD categories was also examined. METHOD: Participants (N = 195) read definitions of SMI and SUD and completed an online survey of their agreement on: perceptions of recovery from SMI and SUD as outcome and process, and expectations of recovery as outcome and process. Participants were then given more and less severe SMI (i.e., schizophrenia vs. depression) and SUD (opiate vs. alcohol use) definitions. They then responded to recovery items SMI and SUD conditions with low and high severity. RESULTS: For SMI, perceptions and expectations of recovery as process were endorsed more than outcome. Severity effect led to greater increases in perceptions and expectations about recovery as process. Specifically, differences between outcome and process for schizophrenia were significantly larger than for depression. For SUD, expectations of process were significantly lower than outcome ratings. One negative interaction was found for SUD expectations; difference scores for opiate users were smaller than for alcohol. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: We discussed implications for interventions that enhance recovery for people with SMI and SUD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

We provide three examples of how addiction stigma is sanctioned: (a) discrimination against people with addictions is often legal; (b) public health communications frequently use stigma to promote prevention; (c) some programmes, such as '12 steps' promote self-stigma. The implications of sanctioned stigma for stigma-change programmes are then discussed.

BACKGROUND AND OBJECTIVES: Although advocates and providers identify stigma as a major factor in confounding the recovery of people with SUDs, research on addiction stigma is lacking, especially when compared to the substantive literature examining the stigma of mental illness. METHODS: A review of key studies from the stigma literature that yielded empirically supported concepts and methods from the mental health arena was contrasted with the much smaller and mostly descriptive findings from the addiction field. RESULTS: Integration of this information led to Part I of this two part paper, development of a research paradigm seeking to understand phenomena of addiction stigma (eg, stereotypes, prejudice, and discrimination) and its different types (public, self, and label avoidance). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: In Part II paper (American Journal of Addictions, Vol 26, pages 67-74, this issue), we address how this literature informs a research program meant to develop and evaluate and stigma strategies (eg, education, contact, and protest). Both papers end with recommendations for next steps to jumpstart the addiction stigma portfolio. Here in Part I, we offer one possible list of key research issues for studies attempting to describe or explain addiction stigma. (Am J Addict 2017;26:59-66).

BACKGROUND AND OBJECTIVES: Although advocates and providers identify stigma as a major factor in confounding the recovery of people with SUDs, research on addiction stigma is lacking, especially when compared to the substantive literature examining the stigma of mental illness. METHODS: A comprehensive review of the stigma literature that yielded empirically supported concepts and methods from the mental health arena was contrasted with the much smaller and mostly descriptive findings from the addiction field. In Part I of this two part paper (American Journal of Addictions, Vol 26, pages 59-66, this issue), constructs and methods from the mental health stigma literature were used to summarize research that seeks to understand the phenomena of addiction stigma. RESULTS: In Paper II, we use this summary, as well as the extensive literature on mental illness stigma change, to outline a research program to develop and evaluate strategies meant to diminish impact on public and self-stigma (eg, education and contact). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The paper ends with recommendations for next steps in addiction stigma research. (Am J Addict 2017;26:67-74).