Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment.
chronic disease
opioid use disorder
policy
public stigma
survivorship model
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
14
06
2022
accepted:
21
10
2022
pmc-release:
01
05
2024
medline:
29
5
2023
pubmed:
18
11
2022
entrez:
17
11
2022
Statut:
ppublish
Résumé
The chronic disease model of opioid use disorder (OUD) is promoted by many public health authorities, yet high levels of stigma persist along with low support for policies that would benefit people with OUD. Determine if a survivorship model of OUD, which does not imply a chronic, relapsing disease state, compared to a chronic disease model improves public stigma and support for opioid-related policies. Explore if race or gender moderates any effect. Online, vignette-based randomized study. US adults recruited through a market research firm. Participants viewed one of 8 vignettes depicting a person with OUD in sustained remission. Vignettes varied in terms of the OUD model (survivorship, chronic disease) and vignette individual's race (Black, White) and gender (man, woman). (1) Public stigma measured by desire for social distance, perceptions of dangerousness, and overall feelings toward the vignette individual. (2) Support for 7 opioid-related policies. Overall feelings were measured on a feelings thermometer (0/cold-100/warm). Stigma and policy support responses were measured on Likert scales dichotomized to indicate a positive (4, 5) or negative/indifferent (1-3) response. Of 1440 potential participants, 1172 (81%) were included in the analysis. Exposure to the survivorship model resulted in warmer feelings (mean 72, SD 23) compared to the chronic disease (mean 67, SD 23; difference 4, 95%CI 1-6). There was no effect modification from the vignette individual's race or gender. There was no significant difference between OUD models on other measures of public stigma or support for policies. The survivorship model of OUD improved overall feelings compared to the chronic disease model, but we did not detect an effect of this model on other domains of public stigma or support for policies. Further refinement and testing of this novel, survivorship model of OUD could improve public opinions.
Sections du résumé
BACKGROUND
The chronic disease model of opioid use disorder (OUD) is promoted by many public health authorities, yet high levels of stigma persist along with low support for policies that would benefit people with OUD.
OBJECTIVE
Determine if a survivorship model of OUD, which does not imply a chronic, relapsing disease state, compared to a chronic disease model improves public stigma and support for opioid-related policies. Explore if race or gender moderates any effect.
DESIGN
Online, vignette-based randomized study.
PARTICIPANTS
US adults recruited through a market research firm.
INTERVENTION
Participants viewed one of 8 vignettes depicting a person with OUD in sustained remission. Vignettes varied in terms of the OUD model (survivorship, chronic disease) and vignette individual's race (Black, White) and gender (man, woman).
MAIN MEASURES
(1) Public stigma measured by desire for social distance, perceptions of dangerousness, and overall feelings toward the vignette individual. (2) Support for 7 opioid-related policies. Overall feelings were measured on a feelings thermometer (0/cold-100/warm). Stigma and policy support responses were measured on Likert scales dichotomized to indicate a positive (4, 5) or negative/indifferent (1-3) response.
KEY RESULTS
Of 1440 potential participants, 1172 (81%) were included in the analysis. Exposure to the survivorship model resulted in warmer feelings (mean 72, SD 23) compared to the chronic disease (mean 67, SD 23; difference 4, 95%CI 1-6). There was no effect modification from the vignette individual's race or gender. There was no significant difference between OUD models on other measures of public stigma or support for policies.
CONCLUSIONS
The survivorship model of OUD improved overall feelings compared to the chronic disease model, but we did not detect an effect of this model on other domains of public stigma or support for policies. Further refinement and testing of this novel, survivorship model of OUD could improve public opinions.
Identifiants
pubmed: 36394698
doi: 10.1007/s11606-022-07865-y
pii: 10.1007/s11606-022-07865-y
pmc: PMC10212853
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1638-1646Subventions
Organisme : NIAAA NIH HHS
ID : K24 AA027483
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.
Références
Am J Public Health. 2016 Dec;106(12):2127-2129
pubmed: 27831792
JAMA Netw Open. 2022 Jul 1;5(7):e2222149
pubmed: 35838672
J Addict Med. 2022 Jan-Feb 01;16(1):77-83
pubmed: 33758119
J Gen Intern Med. 2022 Feb;37(3):593-600
pubmed: 34027611
Med Anthropol Q. 2019 Jun;33(2):242-262
pubmed: 29700845
Am J Public Health. 1974 Dec;64 Suppl 12:38-43
pubmed: 4429174
Addiction. 2021 Jul;116(7):1757-1767
pubmed: 33197084
Ann Intern Med. 2020 Jul 21;173(2):160-162
pubmed: 32311740
N Engl J Med. 2020 Apr 2;382(14):1289-1290
pubmed: 32242351
N Engl J Med. 2016 Jan 28;374(4):363-71
pubmed: 26816013
Drug Alcohol Depend. 2016 Dec 01;169:85-91
pubmed: 27792911
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Psychol Sci. 2009 Feb;20(2):169-73
pubmed: 19175755
Am J Psychiatry. 2010 Nov;167(11):1321-30
pubmed: 20843872
J Consult Psychol. 1957 Apr;21(2):95-103
pubmed: 13416422
J Health Soc Behav. 2005 Dec;46(4):307-22
pubmed: 16433278
JAMA Psychiatry. 2019 Sep 1;76(9):979-981
pubmed: 31066881
Clin Psychol Rev. 2013 Aug;33(6):782-94
pubmed: 23831861
Soc Sci Med. 2015 Feb;126:73-85
pubmed: 25528557
Med Clin North Am. 2022 Jan;106(1):219-234
pubmed: 34823732
Subst Abuse. 2015 Sep 20;9(Suppl 2):1-4
pubmed: 26448685
Health Aff (Millwood). 2021 Jun;40(6):920-927
pubmed: 34097509
Int J Drug Policy. 2020 Jun;80:102769
pubmed: 32446183
N Engl J Med. 2018 Dec 20;379(25):2438-2450
pubmed: 30575480
J Gen Intern Med. 2019 Jun;34(6):1039-1042
pubmed: 30729416
Neuropsychopharmacology. 2021 Sep;46(10):1715-1723
pubmed: 33619327
Addiction. 2020 Dec;115(12):2317-2326
pubmed: 32219910
Addiction. 2011 Mar;106(3):657-69
pubmed: 21077975
Behav Res Methods. 2015 Dec;47(4):1122-1135
pubmed: 25582810
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Am J Public Health. 2022 Apr;112(S2):S104-S108
pubmed: 35349310
Prev Med. 2018 Jun;111:73-77
pubmed: 29481827
Subst Abus. 2018;39(4):419-425
pubmed: 29932847
Am J Psychiatry. 2022 Nov 1;179(11):807-813
pubmed: 35410494
Curr Opin Psychiatry. 2021 Jul 1;34(4):344-350
pubmed: 33965972
Psychiatr Serv. 2017 May 1;68(5):462-469
pubmed: 28045350
Cult Med Psychiatry. 2016 Dec;40(4):664-686
pubmed: 27272904