LAUSR

Many individuals who suffer from opioid use disorder (OUD) experience symptoms of insomnia. OUD-related stigma and discrimination are major concerns and represent complex, chronic stressors that lead to negative health and social outcomes. However, how OUD-related stigma and discrimination are associated with insomnia among those on Medication for OUD (MOUD) is not known. The purpose of this study is to examine the associations among OUD-related stigma, intersectional discrimination, and insomnia among patients on MOUD. This concurrent mixed methods study is a sub-study (N = 120) of the NIH funded Collaboration Linking Opioid Use Disorder and Sleep (CLOUDS) study. Insomnia was measured with the Insomnia Severity Index. OUD-related stigma was assessed with the Brief Opioid Stigma Scale, and intersectional discrimination was assessed with the Intersectional Discrimination Index. Quantitative data were analyzed via Spearman correlations. A sub-sample of 25 participants participated in semi-structured interviews. Qualitative questions explored individuals’ perceptions and experiences of stigma and discrimination and their influence on sleep. Qualitative data were analyzed with thematic analysis. Hypotheses were partially supported. Spearman correlations revealed a small positive correlation (r = .17, p = .04) between intersectional discrimination and insomnia severity. Correlations between OUD-related stigma and insomnia severity were not statistically significant. Patterns of negative thinking and rumination were described by participants who felt their stigmatizing and discriminatory experiences affected their sleep. Findings add to the growing literature linking discrimination to sleep deficiency in highly stigmatized populations. With larger diverse samples, future researchers should (1) utilize longitudinal designs to explore underlying pathways by which discrimination and stigma affect sleep and (2) identify intervention approaches that target multiple levels [individual, interpersonal, community, and structural] to decrease the impacts of discrimination and stigma on self-perception and sleep outcomes for those battling OUD.