Despite recent policy strides like decriminalization in Oregon and authorization of a safe consumption site pilot in Rhode Island, a new pilot survey finds that “alarmingly high levels of perceived societal stigma” persist against people who use drugs.
The survey—a collective effort from harm reduction organization Elevyst, data analysis firm RIWI, and the Pennsylvania Recovery Organizations Alliance (PRO-A)—anonymously surveyed 26,000 US-based people online over the summer about how they think society perceives people who use drugs.
Seventy-one percent of respondents believed that society at large considers people who use drugs problematically—who are, of course, only a small subset of all drug users—to be “outcasts or non-community members.” Seventy-four percent believed that society views people who use drugs problematically as “somewhat, mostly, or entirely responsible for their drug use.”
Out of 15 stigma-related questions asked, only one—“Is a person who takes medications for their addiction (i.e. to reduce cravings or withdrawal symptoms) considered to be in recovery?”—addressed the respondents’ own stigma (28 percent of respondents believed this “always” to be the case). The other quesitons addressed perceptions of societal stigma—a deliberate choice to limit the impact of social desirability bias in responses.
“The time to change these attitudes is now and we have the tools to do it.”
Dr. Rikki Sargent, analytics and data strategies lead at RIWI, told Filter that the stigma composite score can be broken down to get 11 components of stigma—like perceptions of competence, or personal responsibility.
“Then one can see if there’s a certain component that’s more present in certain communities, then develop unique stigma prevention interventions in those communities,” Sargent said. “This approach is a lot less common in the stigma literature, and it is really comprehensive.”
Even as harm reduction is increasingly mainstreamed, damaging narratives that people who use drugs must be saved from themselves via continuous state interventions like supervised probation and drug courts endure. These also provide campaign trail fodder for elected law enforcement leaders outside of the nation’s most liberal cities.
“For the first time ever, we can use near real-time data with large, representative samples to develop and target interventions focused on improving public perceptions about people like me,” said PRO-A executive director Bill Stauffer, who is in long-term recovery. “Expanding access to services support while getting rid of underlying discriminatory practices. The time to change these attitudes is now and we have the tools to do it.”
Filter was able to view the survey’s underlying data, which will be released in a forthcoming, separate report. One of the most striking findings was that Pennsylvanians seem to have a particularly low opinion of the societal standing of people who use drugs—at least when compared with residents of other big states such as California, Illinois, New York and Florida.
The survey will remain active, with hopes of measuring changing levels of stigma in the US and potentially expanding internationally. RIWI’s technology generates a unique sample of respondents every day, which makes it ideal for measuring “before and after” results for various public health initiatives and other events.
“We need to continuously ask whether things are actually getting better. Are we measuring what we’re doing to reduce stigma, then acting accordingly?” Sean Fogler, MD, the co-founder of Elevyst and a physician in recovery, told Filter. “Currently, the answer is no.”