What do people in Indiana really think about opioid dependence?
Brea Perry, professor of sociology at IU, is leading a project through IU’s Responding to the Addictions Crisis Grand Challenge aimed at answering that question. The research team will use these findings to guide and test community-specific interventions to increase recovery rates and save lives by addressing the negative attitudes about opioid users that often become barriers to treatment and recovery.
The research project titled "Opioid Aaddiction and public stigma: an assessment of rural and urban Indiana communities," involves surveys of more than two thousand Hoosiers, focusing in particular on counties that have been hardest hit by the opioid crisis and including hundreds of individuals that have self-identified as opioid users. Working with community partners, survey responses will be used to develop local campaigns and programs designed to address each community’s particular barriers to treatment.
Perry’s project focuses on stigma, one of the primary barriers to overcoming drug addiction. Defined as an attitude that discredits or devalues individuals associated with a particular condition, stigma is experienced both as negative, discriminatory treatment from others and also as internalized, self-directed judgement. Although stigma is known to worsen health and social problems by encouraging secrecy and reducing public support for solutions, questions remain about how stigma arises and how it can be overcome.
The project will fill this knowledge gap by testing a theory, developed by IU Distinguished Professor Bernice Pescosolido, that maps the various components of stigma. This “stigma complex” includes economic factors, media messages, community characteristics, social relationships, and individual mindsets that all interact to shape attitudes and beliefs.
Perry’s team will use their data to validate and build on this model to determine the mechanisms by which stigma obstructs opioid treatment and recovery. This understanding will enable the researchers to work with community partners in the Stigma Research, Intervention, and Stakeholder Coalition to craft locally targeted programs and policy initiatives.
A distinguishing feature of the study is its interest in locally specific components of stigma; existing research has generally treated stigma as a widespread, uniform phenomenon. Where differences in stigma have been considered, these comparisons have been made across countries.
Perry’s project is the first known study to examine how stigma differs across contexts within one state. Opioid dependence is a particularly compelling case for this research as it is distinct from other types of drug addiction in several ways: it affects greater proportions of women, whites, middle class Americans and rural and suburban residents; it is viewed as being attributable, at least in part, to factors outside an individual’s control; it affects a sizable number of people who began taking opioids through prescribed pain management for injury or chronic illness; and it has infiltrated some communities far more than others, in some cases to a devastating degree.
The research team is able to conduct this large-scale study due to its involvement with another Grand Challenges effort: The Person to Person Health Interview Study associated with the Precision Health Grand Challenge.