Stigma and policy preference toward individuals who transition from prescription opioids to heroin

There is a lack of understanding of what contributes to attitudes toward individuals with an opioid addiction and preferences for policies that support them.

This study aimed to investigate stigmatization of an opioid addiction and support for publicly funded drug treatment. A randomized, between-subjects case vignette study (N = 1998) was conducted with a nation-wide online survey. To assess public perceptions of stigma and support for publicly funded drug treatment, participants rated a hypothetical individual who became addicted to prescription opioids across three conditions: 1) male or female, 2) an individual who was prescribed prescription painkillers or took prescription painkillers from a friend and 3) an individual who transitioned to using heroin or who continued using prescription painkillers.

Our results showed that there were stronger negative attitudes towards a male (p < .01) and toward an individual who took prescription painkillers from a friend (all p's < .05), and both stronger positive and negative attitudes toward an individual who transitioned to heroin from prescription painkillers (all p's < .05). Next, we demonstrated that the probability that someone supports publicly funded drug treatment increases by 3.6 percentage points for each unit increase along a 12-point scale of positive attitudes (p < .0005), 1.3 percentage points for each unit decrease along a 12-point scale of negative attitudes (p < .005), 7.3 percentage points for each unit increase along a 6-point scale of perceived treatment efficacy (p < .0001), 0.1 percentage points for each unit decrease along a 100-point scale that measures the strength of one's belief that addiction is controllable (p < .005) and 0.2 percentage points for each unit decrease along a 100-point scale that measures the strength of one's belief that income is controllable (p < .005). Lastly, when controlling for the effects of stigma, the probability of supporting publicly funded drug treatment decreases by 6.3 percentage points (p < 0.001) when an individual was prescribed prescription painkillers from a doctor. However, path analysis identified a channel through which a doctor's prescription increased support for publicly funded drug treatment by influencing positive attitudes, negative attitudes, and responsibility.

Our findings provide further evidence that information about individuals who become addicted to opioids can influence stigma perceptions and support for publicly funded drug treatment.