The unique nature of public stigma toward non‐medical prescription opioid use and dependence: a national study

BACKGROUND AND AIMS Our ability to combat the opioid epidemic depends, in part, on dismantling the stigma that surrounds drug use. However, this epidemic has been unique and, to date, we have not understood the nature of public prejudices associated with it. Here, we examine the nature and magnitude of public stigma toward prescription opioid use disorder (OUD) using the only nationally representative data available on this topic. DESIGN General Social Survey (GSS), a cross-sectional, nationally representative survey of public attitudes. SETTING United States, 2018. PARTICIPANTS/CASES A total of 1169 US residents recruited using a probability sample. MEASUREMENTS Respondents completed a vignette-based survey experiment to assess public stigma toward people who develop OUD following prescription of opioid analgesics. This condition is compared with depression, schizophrenia, alcohol use disorder (AUD) and subclinical distress using multivariable logistic or linear regression. FINDINGS Adjusting for covariates (e.g. race, age, gender), US residents were significantly more likely to label symptoms of OUD a physical illness [73%, confidence interval (CI) = 66-80%; P