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The unique nature of public stigma toward non‐medical prescription opioid use and dependence: a national study
Author(s) -
Perry Brea L.,
Pescosolido Bernice A.,
Krendl Anne C.
Publication year - 2020
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15069
Subject(s) - opioid use disorder , medicine , psychiatry , cross sectional study , vignette , logistic regression , medical prescription , demography , public health , confidence interval , stigma (botany) , opioid , psychology , social psychology , receptor , pharmacology , nursing , pathology , sociology
Background and Aims Our ability to combat the opioid epidemic depends, in part, on dismantling the stigma that surrounds drug use. However, this epidemic has been unique and, to date, we have not understood the nature of public prejudices associated with it. Here, we examine the nature and magnitude of public stigma toward prescription opioid use disorder (OUD) using the only nationally representative data available on this topic. Design General Social Survey (GSS), a cross‐sectional, nationally representative survey of public attitudes. Setting United States, 2018. Participants/Cases A total of 1169 US residents recruited using a probability sample. Measurements Respondents completed a vignette‐based survey experiment to assess public stigma toward people who develop OUD following prescription of opioid analgesics. This condition is compared with depression, schizophrenia, alcohol use disorder (AUD) and subclinical distress using multivariable logistic or linear regression. Findings Adjusting for covariates (e.g. race, age, gender), US residents were significantly more likely to label symptoms of OUD a physical illness [73%, confidence interval (CI) = 66–80%; P < 0.001] relative to all other conditions, and less likely to label OUD a mental illness (40%, CI = 32–48%; P < 0.001). OUD was significantly less likely to be attributed to bad character (37%, CI = 30–44%; P < 0.001) or poor upbringing (17%, CI = 12–23%; P < 0.001) compared with AUD. Nonetheless, perceptions of competence associated with OUD (e.g. ability to manage money; 41%, CI = 33–49%; P < 0.01) were lower than AUD, depression and subclinical distress. Moreover, willingness to socially exclude people with OUD was very high (e.g. 76% of respondents do not want to work with a person with OUD), paralleling findings on traditional targets of strong stigma (i.e. AUD and schizophrenia). Conclusions US residents do not typically hold people with prescription opioid use disorder responsible for their addiction, but they express high levels of willingness to subject them to social exclusion.