From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (JCS); Center for Behavioral Health and Justice, School of Social Work, Wayne State University, Detroit, MI (GV, BR).
J Addict Med. 2022;16(5):563-569. doi: 10.1097/ADM.0000000000000971.
Despite billions of dollars spent on opioid policy initiatives, public knowledge of evidence-based policies to reduce opioid-related morbidity remain low. Consequences of this knowledge gap for support of initiatives remains understudied. Our objective was to evaluate how participants with and without lived experience allocate funding for initiatives to address the opioid epidemic. A secondary objective was to collect proof-of-concept data of an informational intervention designed to improve support for evidence-based policies.
Participants (N = 284; 57.2% female) without lifetime nonmedical opioid use (n = 98) and those with lifetime use (past year [n = 81] or nonpast year [n = 105]) of nonmedical opioids were recruited. All participants reported how they would allocate funds to demand reduction, supply reduction, harm reduction, and treatment policies. Half of all participants were then randomized to a brief informational intervention designed to emphasize evidence-based harm reduction and treatment programs.
Funding allocations were highest for policies related to community services and treatment and lowest for those related to harm reduction. Participants with lived experience allocated less to supply reduction policies. Participants (12%) who reallocated funds after information exposure increased funding to supervised consumption sites, dz = 0.77, naloxone distribution, dz = 0.85, syringe exchange programs, dz = 0.63, and medications for opioid use disorder access, dz = 0.70.
This study illustrates how people with and without lived experience prioritize various policies to address the opioid epidemic and emphasize comparably low support for harm reduction policies. Proof-of-concept data suggest that brief informational interventions may increase funding support for harm reduction strategies, at least in a subset of people.
尽管在阿片类药物政策举措上投入了数十亿美元，但公众对减少阿片类药物相关发病率的循证政策的了解仍然很低。这一知识差距对支持这些举措的后果仍研究不足。我们的目的是评估有和没有亲身经历的参与者如何为解决阿片类药物流行问题的倡议分配资金。次要目标是收集旨在提高对循证政策支持的信息干预措施的概念验证数据。
招募了没有终身非医疗用阿片类药物使用史的参与者（n = 98）和有终身非医疗用阿片类药物使用史的参与者（过去一年[n = 81]或非过去一年[n = 105]）。所有参与者都报告了他们将如何分配资金用于减少需求、减少供应、减少伤害和治疗政策。然后，将所有参与者随机分为一半，接受旨在强调循证减少伤害和治疗计划的简短信息干预。
与社区服务和治疗相关的政策分配资金最高，与减少伤害相关的政策分配资金最低。有亲身经历的参与者对减少供应的政策分配较少。在信息曝光后重新分配资金的参与者（12%）增加了对监督消费场所、dz = 0.77、纳洛酮分发、dz = 0.85、注射器交换计划、dz = 0.63 和阿片类药物使用障碍获取药物的资金支持。
这项研究说明了有和没有亲身经历的人如何优先考虑各种政策来解决阿片类药物流行问题，并强调对减少伤害政策的支持相对较低。概念验证数据表明，简短的信息干预措施可能会增加对减少伤害策略的资金支持，至少在一部分人中是这样。
