Silent struggles: a qualitative inquiry into stigma experienced by caregivers of substance use disorder (SUD) patients

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, specifi cally in Odisha. A qualitative phenomenological design was employed to understand caregivers’ personal narratives and perceptions of stigma in caregiving for individuals with SUD. A qualitative phenomenological study was conducted at a tertiary mental health and de-addiction center in Bhubaneswar, Odisha. Purposive sampling was used to recruit primary caregivers of individuals with substance use disorder (SUD). Among 15 eligible caregivers approached, four declined participation and one withdrew, resulting in 10 completed interviews for final analysis. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s six-phase thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Five overarching themes were identifi ed: (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. 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.