Notice of Special Interest (NOSI): Strategies to Address Stigmatizing Beliefs and Policies Affecting People Who Use Drugs
Notice Number:

Key Dates

Release Date:

February 1, 2024

First Available Due Date:
June 05, 2024
Expiration Date:
January 08, 2027

Related Announcements

  • May 11, 2021- Pilot Health Services and Economic Research on the Treatment of Drug, Alcohol, and Tobacco Use Disorders (R34 - Clinical Trial Optional). See NOFO PA-21-180
  • May 5, 2020- NIH Research Project Grant (Parent R01 Clinical Trial Required). See NOFO PA-20-183
  • May 5, 2020 -NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed). See NOFO PA-20-185

Issued by

National Institute on Drug Abuse (NIDA)


People who use drugs experience stigma from different sources and in a variety of contexts, all of which are associated with negative outcomes. Some common stigmatizing beliefs directed toward people who use drugs include the notion that drug use is a personal choice, that people with substance use disorders (SUD) can stop using drugs if they have enough willpower, and that people with SUD are dishonest and immoral. These beliefs can manifest through negative interactions with friends and family members as well as through unpleasant encounters with healthcare providers. Stigma also exists at the structural level, such as through public policies that criminalize people with SUD. People who use drugs may also experience self-stigma, which occurs when they internalize stereotypes associated with substance use and direct these beliefs toward themselves. As a result, they often opt to not disclose to other people that they have SUD. 

Stigma directed toward people who use drugs has been linked to many negative outcomes, including increases in drug use; a lower likelihood of obtaining and completing SUD treatment, including reluctance to utilizing medications for opioid use disorder or premature discontinuation of these effective medications; housing instability; criminal-legal involvement; social isolation; physical and mental health challenges; and challenges with managing acute and chronic pain among people who use drugs. The numerous negative outcomes associated with stigma highlight the need for rigorous research on ways to address stigma and its associated consequences. Therefore, this NOSI highlights support for research to develop, adapt, and/or test strategies aimed at addressing stigma at the individual, interpersonal, and/or structural levels. 

Types of stigma that are of interest for this NOSI include but are not limited to:

  • Structural-level stigma, such as policies that criminalize drug use and prohibit individuals who have SUD and/or take methadone from obtaining public housing; punitive responses to substance use and SUD among pregnant and parenting people; negative drug test requirements for obtaining and maintaining employment; inadequate provider reimbursement; and omission of medications for opioid use disorder (MOUD) from formularies.
  • Interpersonal-level stigma, such as stigma from friends, family members, coworkers, supervisors, law enforcement officers, and healthcare providers. Healthcare providers may include doctors, nurses, medical assistants, administrative staff, pharmacists, emergency medical responders, and physical and behavioral health treatment providers who are philosophically opposed to prescribing MOUD or providing harm reduction services for people with SUD.
  • Individual-level stigma, including self-stigma and internalized stigma.

Applicants are encouraged to examine how these strategies and interventions not only address stigma, but also impact the negative consequences of stigma. Outcomes of interest include but are not limited to:

  • Decreasing substance use and overdose rates
  • Increasing the likelihood of SUD treatment referral, access, initiation, engagement, and retention
  • Increasing the likelihood that healthcare providers and other employees at healthcare organizations, including administrative staff, receive substance use education and stigma awareness and reduction training
  • Increasing the availability of SUD service providers, including those who provide MOUD
  • Increasing access to and engagement with harm reduction services
  • Improving experiences with service providers and the quality of care 
  • Increasing social connectedness, housing stability, and employment
  • Decreasing criminal-legal involvement
  • Addressing co-morbid physical and mental health conditions 
  • Reducing misinformation regarding substance use
  • Improving acute and chronic pain management among people who use drugs

Other considerations:

  • Applicants should ensure that interventions and strategies being developed, adapted and/or tested in response to this NOSI are scalable, sustainable, and impact diverse populations, including those from NIH-designated populations that experience health disparities and other underserved groups. See:
  • Applicants are encouraged to focus on addressing more than one type of stigma in their studies and, if relevant, intersectional stigma, which occurs when an individual or a group experiences stigma related to more than one of their identities.
  • In addition to assessing the effectiveness of interventions, applicants are encouraged to explore barriers of and facilitators to successful implementation of stigma interventions, such as intervention characteristics, settings, and processes.
  • Applicants are strongly encouraged to engage stakeholders and potential end users of their research, including people with lived experience, in the design and implementation of their studies. 

Application and Submission Information

Submit applications for this initiative using one of the following notice of funding opportunity (NOFO) or any reissues of these announcements through the expiration date of this notice.

  • PA-20-183 - NIH Research Project Grant (Parent R01 Clinical Trial Required)
  • PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
  • PA-21-180 - Pilot Health Services and Economic Research on the Treatment of Drug, Alcohol, and Tobacco Use Disorders (R34 - Clinical Trial Optional)

All instructions in the SF424 (R&R) Application Guide and the notice of funding opportunity used for submission must be followed, with the following additions:

  • For funding consideration, applicants must include “NOT-DA-25-029” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.


Please direct all inquiries to the Scientific/Research, Peer Review, and Financial/Grants Management contacts in Section VII of the listed notice of funding opportunity.

Julia Zur, PhD
National Institute on Drug Abuse (NIDA)
Phone: 301-443-2261