Opioid use and stigma: The role of gender, language and precipitating events

Drug Alcohol Depend. 2018 Apr 1;185:339-346. doi: 10.1016/j.drugalcdep.2017.12.037. Epub 2018 Feb 23.


The stigma of drug addiction is associated with negative perceptions and can be a barrier to treatment. With the rise in opioid overdose deaths, understanding stigmatizing attitudes towards individuals who use opioids is a crucial matter. There is a lack of opioid use research on stigma and, therefore, we aimed to discern stigmatizing attitudes towards people with opioid addiction. A randomized, between-subjects case vignette study (n = 2605) was conducted with a nation-wide online survey. Participants rated a hypothetical individual addicted to opioids on different dimensions of stigma after seeing one version of a vignette that varied by three conditions: 1) a male versus a female, 2) an individual labeled as being a "drug addict" versus having an "opioid use disorder" and 3) an individual whose use started by taking prescription opioids from a friend versus receiving a prescription from a doctor. Our results indicated that there were higher stigmatizing attitudes overall towards a male, an individual labeled as a "drug addict" and an individual who took prescription opioids from a friend. Interaction effects also showed that a female labeled with an "opioid use disorder" and male labeled as a "drug addict" were rated with higher stigma. The findings from our study are the first to show that information about gender, precipitating events and language matter when assessing stigma and opioid use and may affect the delivery of patient care.

Keywords: Gender; Language; Nonmedical prescriptions; Opioid use disorder; Opioids; Stigma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Attitude of Health Personnel
  • Behavior, Addictive / diagnosis
  • Behavior, Addictive / psychology*
  • Drug Users / psychology*
  • Female
  • Humans
  • Language*
  • Male
  • Middle Aged
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / psychology*
  • Physicians / psychology*
  • Random Allocation
  • Sex Factors
  • Social Stigma*


  • Analgesics, Opioid