Identifying Populations with High Opioid Use Disorder Stigma: Results from a Multi-State Survey

The United States is experiencing an ongoing opioid epidemic. Despite tragic outcomes and effective treatments, only a small proportion of people with opioid use disorder (OUD) receive care. A primary barrier to treatment is stigma. This study surveyed the general population in 13 Southern states, exploring characteristics associated with high OUD stigma. The authors sought to identify subpopulations with high levels of stigma to inform community anti-stigma education strategies in the South. A sample of 1,676 respondents were surveyed using the Opening Minds Provider Attitudes Towards Opioid-Use Scale (OM-PATOS), and results were analyzed using multiple linear regression. Findings showed that being married, being in a mental health-related workforce profession, and having higher perceived stress were associated with higher stigma scores, while being female or having a history of a behavioral health problem oneself or in one's family was associated with lower stigma. Though additional research is needed, the findings suggest that community-based anti-stigma programming could benefit from targeting groups with high proportions of men and from combining this education with content aimed at stress management. Particularly concerning was the finding that mental health-related workforce professionals held significantly higher stigmatizing beliefs, indicating that outreach to health clinics, mental health centers, pharmacies, and related agencies is needed in community-based anti-stigma campaigns. Organizational partnerships in which members are likely to have low stigma, such as mental health or substance misuse advocacy groups, could benefit from anti-OUD-stigma efforts.