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New Study Shows Promising Support for Syringe Access and Disappointing Opposition to Medication Assisted Treatment

There are many barriers to effectively addressing the opioid epidemic in the United States, but few are as pernicious and intractable as stigma. Much like the response to the HIV epidemic which preceded the opioid epidemic and now coincides with it, public health interventions to curb the spread of opioid use disorders have been routinely stymied by a pervading prejudice and stigma among the general population and even among health care professionals who are untrained in the nature and treatment of substance use disorders. And, while our society’s collective perception of substance use disorders is certainly evolving, it is nowhere near being in line with the latest research and best practices on how to end the opioid epidemic.

According to a recent poll conducted by Politico and Harvard’s T.H. Chan School of Public Health, 37% of Americans still erroneously believe that opioid use disorders are the result of a personal weakness or failing on the part of the individual, while only 1/2 of respondents viewed it as an illness. Similarly, only 1/3 of those polled said that they would consider long-term approaches to opioid use disorder treatment such as Medication-Assisted Treatment (MAT), which use synthetic opioids like methadone or partial opioid agonists like buprenorphine, to be an “effective treatment,” despite MAT being considered the gold standard for treating opioid use disorder by experts in the field.

It is interesting to note that the Politico/T.H. Chan study also broke down attitudes towards the opioid epidemic based on the political affiliation of the respondents. Despite Republican respondents being the most likely to personally know someone who was dealing with an opioid use disorder (36% for those who identified as Republicans compared to 32% for Democrats and 31% for Independents), they were nearly twice as likely as their Democratic counterparts to view opioid use disorders as being a moral weakness (50% for Republicans compared to 27% for Democrats and 35% for Independents). Similarly, Democratic respondents were twice as likely as Republicans to say that they believed the federal government was spending too little on the opioid epidemic.

We should be cautious to read too much into these poll results, but they do fall in line with the ideological cores of both parties’ memberships, with Republican respondents emphasizing personal responsibility—i.e. being more predisposed to believing in the concept of opioid use as moral weakness—and Democratic respondents being more amenable to increased federal funding, with Independents somewhere in the middle.

However, while those results could be reasonably anticipated, the data that came back regarding Medication-Assisted Treatment unequivocally showed that stigma against MAT is universal, with party affiliation having no bearing whatsoever on respondent opinion regarding the use of buprenorphine or methadone. According to the study, only 34% of Republicans and Independents and 33% of Democrats viewed long-term opioid use disorder treatments involving a “milder opioid medicine” to be an effective treatment.

In contrast to this, there was a more encouraging perception of both syringe access programs and safe injection sites. Per the study, the general public was pretty evenly split on the issue of syringe access programs, with 47% of respondents saying they were in favor of them and 48% saying that they were opposed. The partisan split on this issue was the largest of any of the questions posed in the study, with 29% of Republicans supporting syringe access programs compared to 66% of Democrats and 50% of Independents. Opinions on safe injection sites were more negative than for syringe access but, surprisingly, were more positive than for MAT, with 41% expressing support for them compared to 56% who were opposed.

While this is just one study, its findings suggest that public support for syringe access programs are higher now than they have ever been in the past, with the impact of the opioid epidemic on public perception of harm reduction strategies being broad enough to lead more than 2 in 5 respondents to be in favor of historically controversial approaches like the use of safe injection facilities. This bodes well for the future proliferation of syringe access programs across the country and, hopefully, could signal the weakening of the not-in-my-backyard sentiments and stigma that have traditionally served as a massive barrier to the implantation of these programs.

With that being said, this study has also shown that there is still a tremendous amount of stigma and misinformation floating around in the general public about MAT and about what constitutes an effective treatment for opioid use disorder. These results can leave little doubt that dangerous, preconceived notions of opioid use disorder treatment as being relegated to the realm of complete abstinence are still harbored by the majority of Americans, regardless of political affiliation. In order to end the opioid epidemic and prevent massive HIV outbreaks like the one that occurred in Scott County, Indiana, the American people must embrace the most effective treatment methods, which in the case of opioid use disorders means learning to support MAT.

Posted By: AIDS United, Policy Department - Friday, July 27, 2018

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