Experiences of Dehumanization among men with Severe Alcohol Use Disorder and their caregivers in South India: a qualitative study

BACKGROUND: Dehumanization, including disrespect, humiliation, exclusion, and loss of autonomy, is increasingly recognized among individuals with substance use disorders. However, little is known about these experiences among individuals with Severe Alcohol Use Disorders and caregivers in India. OBJECTIVE: To explore Dehumanization experiences among men with Severe Alcohol Use Disorders and caregivers in familial, social, and healthcare contexts. METHODS: A qualitative descriptive study using directed content analysis was conducted with seven men with Severe Alcohol Use Disorders and six primary caregivers at a tertiary-care psychiatric inpatient unit in South India. Participants were recruited purposively. In-depth, semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using a framework-informed content analysis approach guided by Fontesse et al. (2019). Reporting followed Standards for Reporting Qualitative Research guidelines. RESULTS: Eight major themes were organized into three conceptual domains: (1) manifestations and contexts of Dehumanization, encompassing interpersonal, social, and healthcare experiences; (2) consequences and temporal dimensions of Dehumanization; and (3) empowerment and protective processes that may facilitate rehumanization and recovery. Participants described Dehumanization as contributing to emotional distress, social withdrawal, diminished self-worth, and maintenance of alcohol use, while compassionate family and healthcare support promoted hope and recovery. CONCLUSIONS: Dehumanization among persons with Severe Alcohol Use Disorders extends beyond stigma and adversely affects recovery, treatment engagement, and caregiver well-being. Person-centered, recovery-oriented, and rights-based interventions addressing stigma and relational trauma may improve outcomes for individuals with Severe Alcohol Use Disorders and their families.