Illicit drug use is often associated with adverse health and legal consequences, as well as stigma, or social disapproval. Stigma can be viewed as a protective factor against drug use; however, it can also exacerbate the negative social effects experienced by users. Few studies have investigated the stigma associated with drug use in an empirical manner. This study investigated how two forms of stigma, perceived stigma and stigmatization, along with religiosity, explain lifetime drug use among a diverse sample of 1048 emerging adults (18–25 years of age) in New York City. Through a cross-sectional survey design, these factors were examined for the most commonly used illicit drugs among this age group: marijuana, powder cocaine, ecstasy, and nonmedical use of opioids (e.g., Vicodin) and amphetamine (e.g., Adderall). Odds ratios for lifetime use of each drug were modeled using age-adjusted multivariate logistic regressions.

With regard to demographic predictors, females were at half the odds for ecstasy use, and there were no effects of level of educational attainment. However, race/ethnicity was a significant predictor in many models. Specifically, compared to White respondents, Black respondents were at consistently lower odds for marijuana, cocaine and amphetamine use, and Asian American respondents were at consistently lower odds for nonmedical opioid use. Black respondents were also at lower odds for ecstasy use, but the protective effect diminished when controlling for religiosity.

High levels of exposure to users consistently increased the odds of drug use, and high levels of stigmatization consistently decreased the odds of use. Religiosity was only protective for marijuana use and perceived stigma had no effect on use. Findings suggest that stigmatization of users is a protective factor against drug use; however, this is dependent on level of exposure to users. Individuals who devalue drug users are at low odds for use, but the perception of this stigma is not a protective factor against drug use. Public health policy needs to better educate both users and non-users about the health and social consequences of drug use. Alternative protective factors for those who are non-religious and highly exposed to drug users need to be explored.