Estimated Community Stigma Levels Toward Those Who Use Opioids in a Rural Tennessee County

Abstract

One known barrier to opioid and drug use prevention, treatment, and recovery is stigma. Stigma toward those who use drugs is associated with poorer health outcomes and lower life expectancy. Addressing stigma at the individual, provider, and social levels requires understanding the domains of stigma present in a community to target anti-stigma messaging and campaigns. This project aims to describe the level of stigma in law enforcement, a provider, and the community at large and compare the two. A short 21-item Likert-scale (1 = strongly agree to 5 = strongly disagree) questionnaire was developed using previous literature on provider and social-based stigma with the domains of dangerousness, blame, social distance, fatalism, and various perceptions that people have toward those who use drugs. Law enforcement officers were provided an opportunity to answer the questionnaire during a training event in January 2022, while community members were provided an opportunity during the Wilson County Tennessee State Fair in August 2022. Law enforcement (N = 48) and community members (N = 393) differed in demographic makeup, where law enforcement was predominantly more male (77.1% vs. 37.9%), between 30 to 39 years old (35.4% vs. 26.5%), and whiter (91.7% vs. 76.6%). Mean scores within law enforcement in dangerousness (2.03 vs. 2.17), blame (2.48 vs. 2.81), social distance (2.41 vs. 2.73), and fatalism (3.19 vs. 3.31) were consistently worse (lower score = higher stigma). Overall, regardless of whether law enforcement or community-wide, stigma toward those who use drugs in Wilson County, TN is measurably present. Both community members and law enforcement providers have elevated stigma across each domain.