Abstract: Mechanisms of Opioid Stigma Communication: Examining the Impacts of Stigmatizing News Articles about People Who Misuse Opioids
The United States is in the midst of an opioid crisis. Since 1999, nearly half a million people have died as a result of opioid overdoses (CDC, 2017). The opioid epidemic has been fueled by several culprits, including prescription opioids, like Oxycontin and Morphine; synthetic and illicit fentanyl; and heroin. Recent efforts to curb opioid overdose deaths include policy changes to make Naloxone, or Narcan—a life-saving opioid overdose response drug—more publicly available. The push for rehabilitation programs, including medication assisted treatment (MAT), is also at the forefront of the conversation about opioids treatment. As health experts consider the impact of these programs, health communication scholars can uniquely contribute to the dialogue on opioids by investigating the nature and role of messages surrounding opioids. One important area of research concerns stigma communication about opioids and people who misuse opioids. Stigma, a devaluation of a group based on the possession of a discrediting attribute (Goffman, 1963), can have devastating consequences. Among people who misuse opioids, internalized opioid stigma has been positively associated with anxiety and depression (Akdag et al., 2018). Additional research has also found that individuals who express greater stigma toward opioids also express less support for substance use treatment policies and desire more punitive responses to opioids misuse (Kennedy-Hendricks et al., 2017). However, experimental research about the impacts of stigmatizing language on these outcomes is sparse. More investigations are needed to discover the causal relationships between stigma communication and its impacts. The Model of Stigma Communication (MSC, Smith, 2007; Smith, Zhu, & Fink, 2019) provides an apt framework for such a test. The MSC predicts that four features characterize stigma messages, and these four features lead individuals to appraise the stigmatized group as dangerous, therefore leading to more stigma sharing, more desired social distance, more desire for behavioral regulation, and greater stigma beliefs (Smith et al., 2019). However, the MSC is relatively new, has been tested in only a few experimental contexts, and can benefit from additional tests of its mediating pathways. As such, the current study has three primary aims: (1) to test the MSC in a new experimental context (opioids), (2) to compare different potential mechanisms through which stigma messages lead to negative outcomes, and (3) to provide experimental evidence about the negative impacts of stigmatizing language about opioid users. In this aim, an online experimental study was conducted among 231 undergraduate college students. A 2 (classification stigma, including markers and labels: high, low) x 2 (enactment stigma, including responsibility and peril: high, low) between-subjects factorial experiment was used to examine the impact of different message features on study variables. Participants were randomly assigned to one of four experimental messages, which contained a hypothetical news article about a person who misused opioids. Then, participants completed measures of social distance, stigma beliefs, danger appraisal, public policy support, behavioral regulations, and emotional responses. Model comparison and mediation tests should illuminate both theoretical and practical implications.