Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, United States; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, United States.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, United States; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, United States.
Prev Med. 2018 Jun;111:73-77. doi: 10.1016/j.ypmed.2018.02.026. Epub 2018 Feb 23.
We examine Americans' support for two evidence-based harm reduction strategies - safe consumption sites and syringe exchange programs - and their attitudes about individuals who use opioids. We conducted a web-based survey of a nationally representative sample of U.S. adults in July-August 2017 (N = 1004). We measured respondents' support for legalizing safe consumption sites and syringe services programs in their communities and their attitudes toward people who use opioids. We used ordered logistic regression to assess how stigmatizing attitudes toward people who use opioids, political party identification, and demographic characteristics correlated with support for the two harm reduction strategies. Twenty-nine percent of Americans supported legalizing safe consumption sites and 39% supported legalizing syringe services programs. Respondents reported high levels of stigmatizing attitudes toward people who use opioids: 16% of respondents were willing to have a person using opioids marry into their family and 28% were willing to have a person using opioids start working closely with them on a job, and 27% and 10% of respondents rated persons who use opioids as deserving (versus worthless) and strong (versus weak). Stigmatizing attitudes were associated with lower support for legalizing safe consumption sites and syringe services programs. Democrats and Independents were more likely than Republicans to support both strategies. Stigmatizing attitudes toward people who use opioids are a key modifiable barrier to garnering the public support needed to fully implement evidence-based harm reduction strategies to combat the opioid epidemic. Dissemination and evaluation of stigma reduction campaigns are a public health priority.
我们考察了美国人对两种基于证据的减少伤害策略——安全注射点和注射器交换计划——以及他们对使用阿片类药物的个人的态度。我们在 2017 年 7 月至 8 月期间对美国成年人进行了一项基于网络的全国代表性样本调查（N=1004）。我们测量了受访者对在其社区内将安全注射点和注射器服务计划合法化的支持程度，以及对使用阿片类药物的个人的态度。我们使用有序逻辑回归来评估对使用阿片类药物的个人的污名化态度、党派认同以及人口统计学特征与对这两种减少伤害策略的支持程度之间的相关性。29%的美国人支持将安全注射点合法化，39%的人支持将注射器服务计划合法化。受访者报告了对使用阿片类药物的个人的高度污名化态度：16%的受访者愿意让使用阿片类药物的人与其家人结婚，28%的人愿意让使用阿片类药物的人在工作上与他们密切合作，27%和 10%的受访者认为使用阿片类药物的人是值得的（而不是一文不值的）和强壮的（而不是软弱的）。污名化态度与对将安全注射点和注射器服务计划合法化的支持度降低有关。民主党人和独立人士比共和党人更有可能支持这两种策略。对使用阿片类药物的个人的污名化态度是争取公众支持充分实施基于证据的减少伤害策略以对抗阿片类药物流行的关键可改变障碍。减少污名化运动的传播和评估是公共卫生的优先事项。
