Examining the relationship between public stigma, models of addiction, and addictive disorders

The stigmatization of addiction has been identified as a barrier to treatment-seeking among individuals with substance use concerns. Although some evidence exists that beliefs in different models of addiction (MOAs) are associated with stigma, the research is limited in several ways. The aim of the current study is to understand the relationship between different MOAs and public stigma toward substance use disorders and behavioural addictions.

Participants were 755 adults who completed an online survey on MTurk (Mage = 36.2, SD = 10.1, 40.3% women, 59.4% men) and were randomized to one of four vignette conditions describing an individual with alcohol use disorder, opioid use disorder, problem gambling disorder, or diabetes. Participants completed measures assessing perceived stigma towards the vignette character and beliefs related to five MOAs (disease, moral, psychological, sociological, nature).

Stigma ratings were significantly higher in the alcohol and opioid use disorder conditions compared to the problem gambling and diabetes conditions. Greater beliefs in the disease MOA were associated with greater stigma in the problem gambling condition, whereas greater beliefs in the moral MOA were associated with greater stigma in all addiction conditions. Greater beliefs in the psychological MOA were associated with lower stigma in the opioid use disorder and problem gambling conditions.

The current study provides further support that addictive disorders are more stigmatized than other health disorders and suggests that beliefs in specific MOAs are differentially associated with stigma. Interventions addressing addiction stigma may consider incorporating information emphasizing MOAs that are less stigmatizing.