The Influence of Stigmatizing Messages on Danger Appraisal: Examining the Model of Stigma Communication for Opioid-Related Stigma, Policy Support, and Related Outcomes

ABSTRACT

Drug overdose is a leading cause of injury and death in the United States, and opioids are among the most significant of causes. For people with opioid use disorders (OUDs), opioid stigma can lead to devastating consequences, including anxiety and depression. Still, mass media may stigmatize people with OUDs by ascribing stigmatizing labels (e.g., “opioid addict”) and other stigma features to those individuals. However, it is unclear how these stigmatizing messages influence public perceptions of people with OUDs and public support for rehabilitation and Naloxone administration policies. The model of stigma communication (MSC) provides a framework for understanding these relationships. This study used the MSC in two online factorial experiments, the first among college undergraduates (N = 231) and the second among Amazon Mechanical Turk workers (N = 245), to examine how stigmatizing messages about people with OUDs influence stigma-related outcomes. Results reveal that opioid stigma messages influence different outcomes depending on the content of those messages. Classification messages with a stigmatizing mark (e.g., “Alex appears unkempt”) and label (e.g., “opioid addict”) led to greater perceptions of dangerousness and threat in both studies. High stigma classification messages also led to an increased desire for behavioral regulation and social distance in Study 2. Structural equation modeling in Study 1 also supported the applicability of the MSC in the opioid context. Implications for health communication theory development and practice are discussed.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. This study uses people-first language to describe individuals with OUDs. As Broyles et al. (2014) note, people-first language can reduce stigma and counter the stigmatizing language that may otherwise be used to talk about people with OUDs, such as “substance abuser” or “addict.” We want to embody this practice in writing about our research, especially since our research examines how these terms have negative effects.

2. IRB approval was obtained [1389630–2], and signed consent was waived for participants due to the sensitive nature of the topic under study. Participants still completed the informed consent process by reading the consent form and selecting “yes” if they were 18 years or older and agreed to participate in the study.

3. For a complete list of study measures, please contact the primary author.

4. The manipulation attempted to use person-centered language (e.g., “people who misuse opioids” instead of “opioid addicts”) to manipulate classification (Broyles et al., 2014). However, the term “person with an opioid use disorder (OUD)” is the preferable and less stigmatizing term. Unfortunately, the authors learned this after running the experiments.