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Internalized Stigma, Recovery Capital, Family Support, and Social Exclusion in Individuals with Substance Use Problems Receiving Mandated Treatment Under Deferred Prosecution in Taiwan

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Subst Use Misuse. 2026 Sep 8:1-9. doi: 10.1080/10826084.2026.2726528. Online ahead of print.

ABSTRACT

BACKGROUND: Social exclusion is an important but understudied aspect of recovery among individuals receiving mandated addiction treatment under deferred prosecution.

METHODS: Using a cross-sectional survey of 288 participants in Taiwan (85.4% male; mean age = 41.01 years, SD = 10.09), this study tested associations of internalized stigma, recovery capital, and family support with social exclusion, and examined recovery capital as a mediator of the stigma-exclusion association.

RESULTS: Internalized stigma was positively associated with social exclusion, while recovery capital and family support were negatively associated. In the final regression model (43.2% variance explained), recovery capital (β = -0.441, p < 0.001) and family support (β = -0.217, p < 0.001) remained independently associated with lower social exclusion, whereas internalized stigma was no longer significant (β = 0.109, p = 0.061). Recovery capital significantly mediated the stigma-exclusion association even after adjustment for family support (indirect effect = 0.41, 95% CI [0.22, 0.64]).

CONCLUSIONS: These results indicate that social exclusion in this population reflects psychosocial vulnerability, recovery-supporting resources, and relational context, and point to the importance of addressing exclusion directly in recovery and reintegration efforts.

PMID:42711281 | DOI:10.1080/10826084.2026.2726528

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