Public Stigma Toward Female and Male Opium and Heroin Users. An Experimental Test of Attribution Theory and the Familiarity Hypothesis

Abstract

Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (NMensample = 320 and NWomensample = 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., NVignettes = 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used “harder” drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.

Initial Validation and Findings From the Willing/Ready Subscale of the Church Addiction Response Scale

“…However, most of the barriers to readiness revealed by this instrument can be overcome through training regarding the science of addiction including likely origins of addiction and treatment options, as well as interaction with people who are addicted to substances. Both instilling an understanding about origins of addiction such as having a history of adverse childhood experiences (ACEs) ( Felitti et al, 1998 ) and interacting with people who live with addictions both have been shown to reduce stigma at least sometimes ( Corrigan and Nieweglowski, 2019 ; Sattler et al, 2021 ).…”

Effects of media representations of drug related deaths on public stigma and support for harm reduction

“…Furthermore, the 'drug user' label intersects with other characteristics, including those that may be stigmatised (e.g. homelessness; motherhood, socioeconomic deprivation) ( Adley, Atkinson, & Sumnall, 2022 ;Kennedy-Hendricks, McGinty, & Barry, 2016 ;Sattler, Zolala, Baneshi, Ghasemi, & Amirzadeh Googhari, 2021 ). This means that general media-targeted approaches to stigma reduction could generate inequalities, and so research into this topic should aim to simulate real-world reporting as far as possible .…”

“…Attributions can be triggered by information about precipitating events or responses to external labels that result from presentation of target group characteristics and behaviours, including through media, and responses are affected by individual differences in internal perceiver attributes such as empathy, or familiarity with affected groups ( Corrigan & Nieweglowski, 2019 ;Howell, Ulan, & Powell, 2014;Wright, Lopez, & Magyar, 2021 ). Previous studies of stigma towards PWUD that have drawn upon attribution theory, and of relevance to understanding DRD, suggest that the public perceives older people to have greater control of their behaviour, and male PWUD are rated higher than females on attributes such as blame, fear, and anger, whilst those using drugs that are perceived as being more harmful such as heroin are rated as being more responsible for adverse outcomes ( Goodyear, Haass-Koffler, & Chavanne, 2018 ;Sattler, Escande, Racine, & Goritz, 2017 ;Sattler, et al, 2021 ;Witte, Wright, & Stinson, 2019 ).…”

This is your brain on stigma: Stigma attributions resulting from drug-related social marketing

“…In common stigma contexts such as disability or race, uncontrollable causes are attributed, creating less anger and more support (Weiner, 1985). While similar to mental illness, which is increasingly attributed to a biogenetic cause , drug use is unique as it is consistently seen as a controllable choice by the public (Sattler et al, 2021). The public often perceives it as primarily a social problem in comparison to other chronic illnesses, which are considered health problems (McLellan et al, 2000).…”

“…It has been said that social desirability bias limits the collection of accurate data from potential enactors with implicit attitudes differing from views voiced explicitly (Corrigan et al, 2015;Pachankis et al, 2018). This bias may account for the lack of qualitative studies at the individual level, with most studies measuring the levels of stigma estimated at an population level, such as questionnaires and close-ended surveys (see Johnson-Kwochka et al, 2021;Sattler et al, 2021).…”