Kennedy-Hendricks Alene, Barry Colleen L, Gollust Sarah E, Ensminger Margaret E, Chisolm Margaret S, McGinty Emma E
Dr. Kennedy-Hendricks, Dr. Barry, and Dr. McGinty are with the Department of Health Policy and Management and Dr. Ensminger is with the Department of Health, Behavior and Society, all at Johns Hopkins Bloomberg School of Public Health, Baltimore (e-mail:
Psychiatr Serv. 2017 May 1;68(5):462-469. doi: 10.1176/appi.ps.201600056. Epub 2017 Jan 3.
Prescription opioid use disorder and overdose have emerged as significant public health challenges in the past 15 years. Little is known about public attitudes toward individuals who have developed a prescription opioid use disorder and whether these attitudes affect support for policy interventions. This study examined social stigma toward individuals with prescription opioid use disorder and tested whether stigma was associated with support for various policy interventions.
A nationally representative Web-based survey was conducted from January 31 to February 28, 2014. The 1,071 respondents reported on their beliefs about and attitudes toward persons affected by prescription opioid use disorder and rated their support for various policy interventions. Ordered logistic regression models estimated the association between stigma and public support for punitive and public health-oriented policies.
Most respondents viewed this disorder as affecting all groups-racial and ethnic, income, and geographic area of residence groups-fairly equally, despite epidemiological data demonstrating that certain populations have been disproportionately burdened. Respondents expressed high levels of stigma toward individuals with prescription opioid use disorder. Levels of stigma were generally similar among those with and without experience with prescription opioid use disorder, either one's own or that of a relative or close friend. Higher levels of stigma were associated with greater support for punitive policies and lower support for public health-oriented policies.
Reframing the issue to emphasize the structural factors contributing to prescription opioid use disorder and the barriers to accessing evidence-based treatment might improve support for policies that benefit affected individuals.
在过去15年中,处方阿片类药物使用障碍和过量使用已成为重大的公共卫生挑战。对于公众对已患处方阿片类药物使用障碍者的态度以及这些态度是否影响对政策干预措施的支持,人们知之甚少。本研究调查了对处方阿片类药物使用障碍患者的社会污名化情况,并测试了污名化是否与对各种政策干预措施的支持相关。
2014年1月31日至2月28日进行了一项基于网络的全国代表性调查。1071名受访者报告了他们对受处方阿片类药物使用障碍影响者的看法和态度,并对他们对各种政策干预措施的支持程度进行了评分。有序逻辑回归模型估计了污名化与公众对惩罚性政策和公共卫生导向政策支持之间的关联。
尽管流行病学数据表明某些人群负担过重,但大多数受访者认为这种障碍对所有群体——种族和族裔、收入以及居住地区群体——的影响大致相同。受访者对处方阿片类药物使用障碍患者表达了高度的污名化。有或没有自身、亲属或密友处方阿片类药物使用障碍经历的人,污名化程度总体相似。较高的污名化程度与对惩罚性政策的更大支持以及对公共卫生导向政策的较低支持相关。
重新构建问题以强调导致处方阿片类药物使用障碍的结构性因素以及获得循证治疗的障碍,可能会提高对有利于受影响个体的政策的支持。