Examining stigma around opioid use, treatment and overdose prevention in rural communities

• In Event: 2323 - Student Forum Refereed Roundtable
  In Refereed Roundtable 100min: 9. Race, Identity, and Conflicts in Social Lives

Abstract

Background: The prevalence of prescription and non-prescription opioid usage in the U.S. constitutes a deepening public health crisis, particularly in rural communities. Stigma has been demonstrated to serve as one outsized barrier to prevention and treatment; however, there is limited research examining how social attitudes on opioid use render and ultimately manifest in rural settings.

Methods: Between July 2018 and August 2018, semi-structured interviews were conducted with professional and community stakeholders in rural southern Illinois whom interact with people who use opioids (PWUOs). Interviews addressed key informants' general perceptions, and their views of colleagues’ and their communities', around opioid use and PWUOs, and opinions on treatment/harm reduction. Interviews were audio-recorded and transcribed. Transcripts were analyzed in NVivo using abductive analysis.

Results: A total of 30 professional and community stakeholders participated, including staff from local law enforcement offices, courts, health departments, healthcare organizations, treatment centers, EMT units, and community organizations. Most respondents, particularly law enforcement, held at least some negative perceptions of PWUOs and on opioid use, questioning PWUOs’ “moral” character and their functional value, or used stigmatizing language to describe the population (e.g. "addict," "abuser," etc.). Further, local communities were described as largely adversarial towards PWUOs and towards syringe exchanges and overdose reversal agents such as naloxone which were frequently framed as undeserved—or unfair—usages of taxpayer funds.

Conclusion: Stigma against PWUOs was shown to be a pronounced issue in the rural communities surveyed, notably activating at the levels of institution, employee, community, and individual (PWUO) level. Stigma prevention efforts should target the widespread culture of blame towards opioid use and focus on humanizing PWUOs. Further, steps need to be taken to improve public knowledge on the intricate factors contributing to the opioid usage rise and on the moral and fiscal value of harm reduction.

Author

• Jerel Michael Ezell, University of Chicago