This chapter examines the impact of stigma on health care for people with substance use disorders. The authors highlight how stigma exacerbates social exclusion and affects access to treatments, increasing barriers to adequate care and perpetuating prejudices in the health system. Stigma is analyzed at multiple levels, including public stigma, structural stigma, and in the realm of healthcare, underscoring the need for approaches focused on the dignity and rights of the affected people. The text advocates for evidence-based strategies, such as professional education, positive contact, and awareness campaigns to reduce stigma. In addition, it proposes comprehensive policies that combat both stigma and structural inequalities, promoting a more inclusive and humane approach in public health policies in Latin America and Spain.