The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey

Kaynak, Övgϋ; Whipple, Christopher R.; Bonnevie, Erika; Grossman, Joe A; Saylor, Erica; Stefanko, Matthew; McKeon, Courtney; Smyser, Joe; Kensinger, Weston S.

doi:10.1080/10826084.2022.2064506

Cited by 10 publications

(11 citation statements)

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“…8 Furthermore, opioid use disorder is highly stigmatized, which may lead to lower probability of endorsing opioid use disorder symptoms. 8,36,37 In contrast, public atti-tudes have generally become more positive toward cannabis use over the years, in line with the decriminalization of cannabis. 38 Over the years, a number of studies have provided evidence that NSDUH severely underestimates the prevalence of SUDs, 6,10,18 though there are few recent national data to compare with the benchmark multiplier method estimates presented here.…”

Section: Discussionmentioning

confidence: 99%

“…Opioid use disorders are especially common among marginalized population groups that are not adequately captured in general population surveys . Furthermore, opioid use disorder is highly stigmatized, which may lead to lower probability of endorsing opioid use disorder symptoms . In contrast, public attitudes have generally become more positive toward cannabis use over the years, in line with the decriminalization of cannabis …”

Section: Discussionmentioning

confidence: 99%

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Estimating the Prevalence of Substance Use Disorders in the US Using the Benchmark Multiplier Method

Mojtabai

2022

JAMA Psychiatry

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ImportancePrevalence estimates of substance use disorders in the US rely on general population surveys. However, major population groups, such as homeless individuals and institutionalized individuals, are not captured by these surveys, and participants may underreport substance use.ObjectiveTo estimate the prevalence of substance use disorders in the US.Design, Setting, and ParticipantsThe benchmark multiplier method was used to estimate the prevalence of alcohol, cannabis, opioid, and stimulant use disorders based on data from the Transformed Medicaid Statistical Information System (T-MSIS) (the benchmark) and the National Survey on Drug Use and Health (NSDUH) (the multiplier) for 2018 and 2019. T-MSIS collects administrative data on Medicaid beneficiaries 12 years and older with full or comprehensive benefits. NSDUH is a nationally representative annual cross-sectional survey of people 12 years and older. Data were analyzed from February to June 2022.Main Outcomes and MeasuresPrevalence of substance use disorders was estimated using the benchmark multiplier method based on T-MSIS and NSDUH data. Confidence intervals for the multiplier method estimates were computed using Monte Carlo simulations. Sensitivity of prevalence estimates to variations in multiplier values was assessed.ResultsThis study included Medicaid beneficiaries 12 years and older accessing treatment services in the past year with diagnoses of alcohol (n = 1 017 308 in 2018; n = 1 041 357 in 2019), cannabis (n = 643 737; n = 644 780), opioid (n = 1 406 455; n = 1 575 219), and stimulant (n = 610 858; n = 657 305) use disorders and NSDUH participants with 12-month DSM-IV alcohol (n = 3390 in 2018; n = 3363 in 2019), cannabis (n = 1426; n = 1604), opioid (n = 448; n = 369), and stimulant (n = 545; n = 559) use disorders. The benchmark multiplier prevalence estimates were higher than NSDUH estimates for every type of substance use disorder in both years and in the combined 2018 to 2019 sample: 20.27% (95% CI, 17.04-24.71) vs 5.34% (95% CI, 5.10-5.58), respectively, for alcohol; 7.57% (95% CI, 5.96-9.93) vs 1.68% (95% CI, 1.59-1.79) for cannabis; 3.46% (95% CI, 2.97-4.12) vs 0.68% (0.60-0.78) for opioid; and 1.91% (95% CI, 1.63-2.30) vs 0.85% (95% CI, 0.75-0.96) for stimulant use disorders. In sensitivity analyses, the differences between the benchmark multiplier method and NSDUH estimates persisted over a wide range of potential multiplier values.Conclusions and RelevanceThe findings in this study reflect a higher national prevalence of substance use disorders than that represented by NSDUH estimates, suggesting a greater burden of these conditions in the US.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Estimating the Prevalence of Substance Use Disorders in the US Using the Benchmark Multiplier Method

Mojtabai

2022

JAMA Psychiatry

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“…In 2018, 53% of Americans endorsed the belief that addiction was a disease (AP-NORC Center, 2018), but this number has remained relatively unchanged since a previous national survey in 2000(Pew Research, 2001. A recent statewide survey in Pennsylvania found similar results with 56% of respondents agreeing that OUD is a medical illness like diabetes, arthritis, or heart disease (Kaynak et al, 2022). Studies of the association between endorsing the disease model of addiction and stigma have produced mixed results with some claiming little (Meurk et al, 2014) to no effect on public policies (Trujols, 2015).…”

Section: Social Stigma As a Barrier To Opioid Treatment And Recoverymentioning

confidence: 87%

“…One national survey found that 30% of the respondents endorsed that recovery from SUD was impossible and 59% endorsed that SUD treatment was ineffective (Barry et al, 2014). More recently, a statewide survey found fatalism to be lower, with 6% of respondents disagreeing that there are effective treatments available for OUD and 14% disagreeing that recovery from OUD was probable with effective treatment (Kaynak et al, 2022).…”

Section: Social Stigmamentioning

confidence: 99%

Addiction Frameworks, Social Stigma, and NIMBY Syndrome: Examining Barriers to Responding to the Opioid Crisis

Kruis,

Kaynak,

Whipple

et al. 2024

Contemporary Drug Problems

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Scholars have argued that stigma of opioid use disorder (OUD) is a significant barrier to implementing evidence-based responses to the opioid crisis, including the use of medications for opioid use disorder (MOUD). They have also documented a relationship between addiction frameworks and support for punitive responses to substance use. Using a representative sample of Pennsylvania residents ( N = 1,033), the current study synthesizes this literature by empirically examining the relationship between addiction frameworks, opioid-related stigma, and policy-related attitudes (i.e., NIMBY syndrome, support for punitive treatment of OUD, and support for employment discrimination against individuals prescribed MOUD). Results show that support for the disease model of addiction was negatively associated with endorsing NIMBY syndrome for opioid-treatment centers, support for punitive treatment of OUD, and support for employment discrimination against individuals prescribed MOUD; however, these relationships were fully mediated by opioid-related stigma, such that support for the disease model of addiction impacted outcome measures only indirectly through opioid-related stigma. Policy implications are discussed within.

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“…Immediately after completion of the final module, individuals were requested to complete the follow-up survey. The surveys consisted of questions adapted from existing research on substance use and stigma [20][21][22][23], and covered themes related specifically to the content delivered within each module, including: 1) Knowledge about substance use, susceptibility to addiction, and treatment options; 2) Attitudes toward recovery and perceptions of morality; 3) Recognizing the signs of addiction and 4) Awareness of how to help a loved one. The baseline and follow-up surveys contained the same questions, to measure change over time.…”

Section: Methodsmentioning

confidence: 99%

An evaluation of the Just Five program, a flexible digital approach to adult substance use education

Litsky¹,

D’Antonio²,

Bonnevie

2022

PLoS ONE

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Substance use is a steadily worsening crisis, yet there is limited evidence on the effectiveness of brief educational programs related to substance use disorders (SUD). To address this, the Just Five digital program launched in 2019 with six educational lessons about SUD, each five minutes long. Just Five is delivered through various organizations, including employers as part of workplace wellness, health plans that offer it to members, and to community-based organizations and populations they serve. This study evaluated the effectiveness of the program across 10 organizations in the initial launch. A cross-sectional survey was given to Just Five viewers to establish changes in perceived knowledge and attitudes toward SUD. Results were analyzed among the overall sample; a sub-analysis compared results within the three types of organizations taking part. Between December 2019 and September 2021, 2,749 baseline and 397 follow-up surveys were collected. Significant improvements were observed across almost all questions asked, with the largest improvements in respondent confidence to recognize signs of addiction (52.5% baseline; 87.7% follow-up); knowledge about ways to reduce the risk of addiction (54.1% baseline; 86.5% follow-up); and knowledge of how to help someone with addiction (38.7% baseline; 81.7% follow-up). All trends were replicated in sub-analyses. Substance use has severe societal impacts, and there is a need for effective programs that can be quickly implemented across various environments at large scale. Just Five is a potentially effective tool to increase perceived knowledge and improve attitudes toward SUD.

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The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey

Cited by 10 publications

References 70 publications

Estimating the Prevalence of Substance Use Disorders in the US Using the Benchmark Multiplier Method

Estimating the Prevalence of Substance Use Disorders in the US Using the Benchmark Multiplier Method

Addiction Frameworks, Social Stigma, and NIMBY Syndrome: Examining Barriers to Responding to the Opioid Crisis

An evaluation of the Just Five program, a flexible digital approach to adult substance use education

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