Kim Yoonsang, Kresovich Alex, MacLean Kai, Lamuda Phoebe, Ngobo-Ekamby Marie, McQueen Cedasia, Schneider John, Pollack Harold A, Taylor Bruce G
Public Health Department, NORC at the University of Chicago, Chicago, IL, USA.
Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA.
Subst Use Addctn J. 2025 Apr;46(2):220-230. doi: 10.1177/29767342241262556. Epub 2024 Jul 30.
Over 3 million Americans have an opioid use disorder (OUD), and only a fraction receive treatment. Public opinion is crucial in enacting evidence-based policies. Few studies have examined the public's perception of blame for the ongoing opioid overdose epidemic directed at distinct groups. We assessed US adults' perceived blameworthiness for the epidemic and examined factors that may influence the perceived blameworthiness.
We conducted a national survey in 2022 using the AmeriSpeak® panel to assess US adults' perception of blame toward individuals with an OUD and external contributors. Of the 3335 eligible panel members invited to participate, 1233 (37%) completed the survey. We developed a measure of knowledge and understanding of OUD, with a higher value indicating a greater understanding of the nature of OUD and recovery-including knowledge and beliefs on evidence-based treatment and relapse. We analyzed the relationships between sources of blame, knowledge, and understanding of OUD, and individual-level correlates.
Higher score of knowledge and understanding of OUD was associated with lower odds of blaming individuals with OUD (odds ratio [OR] = 0.73, 95% confidence interval [CI] = [0.51, 1.05]) and greater odds of blaming external contributors: healthcare providers (OR = 1.49, 95% CI = [1.05, 2.12]), pharmaceutical companies (OR = 2.17, 95% CI = [1.50, 3.15]), and health insurance companies (OR = 1.42, 95% CI = [0.97, 2.09]). Those who are female, non-Hispanic White, Democrat, have higher education, or have friends or family who misused opioids tended to score higher in knowledge and understanding of OUD.
Perceived blameworthiness for the opioid overdose epidemic is related to knowledge and understanding of OUD. Public health campaigns with a bipartisan agenda to increase evidence-informed knowledge about OUD targeting people of color and with lower education may help reduce the blame toward people with an OUD, which in turn may increase support for evidence-informed policies.
超过300万美国人患有阿片类药物使用障碍（OUD），但只有一小部分人接受治疗。公众舆论对于制定循证政策至关重要。很少有研究调查公众对当前阿片类药物过量流行中不同群体应受指责的看法。我们评估了美国成年人对该流行病的可责难性认知，并研究了可能影响可责难性认知的因素。
我们在2022年利用美国民意调查小组进行了一项全国性调查，以评估美国成年人对患有OUD的个人以及外部促成因素的指责看法。在受邀参与的3335名符合条件的小组成员中，1233人（37%）完成了调查。我们制定了一项对OUD的知识和理解程度的衡量标准，分数越高表明对OUD的性质和康复的理解越深入，包括对循证治疗和复发的知识及信念。我们分析了指责来源、对OUD的知识和理解以及个体层面相关因素之间的关系。
对OUD的知识和理解得分较高与指责患有OUD的个人的可能性较低相关（优势比[OR]=0.73，95%置信区间[CI]=[0.51,1.05]），而指责外部促成因素的可能性更大，这些因素包括医疗保健提供者（OR=1.49，95%CI=[1.05,2.12]）、制药公司（OR=2.17，95%CI=[1.50,3.15]）和健康保险公司（OR=1.42，95%CI=[0.97,2.09]）。女性、非西班牙裔白人、民主党人、受过高等教育的人，或者有朋友或家人滥用阿片类药物的人，在对OUD的知识和理解方面得分往往较高。
对阿片类药物过量流行的可责难性认知与对OUD的知识和理解有关。开展两党议程的公共卫生运动，以增加针对有色人种和低教育程度人群的关于OUD的循证知识，可能有助于减少对患有OUD的人的指责，进而可能增加对循证政策的支持。
