Silent Struggles: A Qualitative Inquiry into Stigma Experienced by Caregivers of Substance use disorder (SUD) Patients

Background This study aimed to explore the lived experiences of stigma among caregivers of individuals with substance use disorder (SUD) in the context of Indian society, specifically in Odisha. A qualitative phenomenological design was employed to understand caregivers' personal narratives and perceptions of stigma in caregiving for individuals with SUD. Methods In-depth semi-structured interviews were conducted with 15 primary caregivers of SUD patients receiving treatment at a mental health and de-addiction center in Bhubaneswar, Odisha. Participants were selected using purposive sampling. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s six-step thematic analysis. The study adhered to COREQ reporting guidelines. Results Five overarching themes were identified: (1) Discordant family relationships, including strained marital dynamics and caregiver health decline; (2) Financial meltdown resulting from treatment costs and loss of income; (3) Psychological abuse experienced by caregivers in the form of verbal or physical aggression; (4) Assigning blame, including scapegoating by family and society; and (5) Social fragmentation and shame due to societal judgment and isolation. The stigma experienced was multifaceted, encompassing emotional, financial, relational, and social dimensions. Conclusion Caregivers of individuals with SUD in India face significant stigma, often compounded by gender roles, community perceptions, and lack of systemic support. These challenges impact caregiver well-being and highlight the need for nurse-led, community-based, and culturally sensitive interventions aimed at caregiver support and stigma reduction.