Dataset Information

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

ABSTRACT: 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.

SUBMITTER: Goodyear K

PROVIDER: S-EPMC6097242 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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

Goodyear Kimberly K Haass-Koffler Carolina L CL Chavanne David D

Drug and alcohol dependence 20180223

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. Parti ...[more]

PMID: 29499554

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Project description:INTRODUCTION:Prior research demonstrates gender differences in language used in letters of recommendation. The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) format limits word count and provides detailed instructions for writers. The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative. METHODS:All applicants to a four-year academic EM residency program within a single application year with a first rotation SLOE available were included in the sample. We used the Linguistic Inquiry and Word Count (LIWC) program to analyze word frequency within 16 categories. Descriptive statistics, chi-squared, and t-tests were used to describe the sample; gender differences in word frequency were tested for using Mann-Whitney U tests. RESULTS:Of 1117 applicants to the residency program, 822 (82%) first-rotation SLOEs were available; 64% were men, and 36% were women. We did not find a difference in baseline characteristics including age (mean 27 years), top 25 schools (22.5%), Alpha Omega Alpha Honor Medical Society rates (13%), and having earned advanced degrees (10%). The median word count per SLOE narrative for men was 171 and for women was 180 (p = 0.15). After adjusting for letter length, word frequency differences between genders were only present in two categories: social words (women: 23 words/letter; men: 21 words/letter, p = 0.02) and ability words (women: 2 words/letter; men: 1 word/letter, p = 0.04). We were unable to detect a statistical difference between men and women applicants in the remaining categories, including words representing communal traits, agentic traits, standout adjectives, grindstone traits, teaching words, and research words. CONCLUSION:The small wording differences between genders noted in two categories were statistically significant, but of unclear real-world significance. Future work is planned to evaluate how the SLOE format may contribute to this relative lack of bias compared to other fields and formats.

Project description:ImportancePersons with opioid use disorder (OUD) and co-occurring alcohol use disorder (AUD) are understudied and undertreated. It is unknown whether the use of medications to treat OUD is associated with reduced risk of alcohol-related morbidity.ObjectiveTo determine whether the use of OUD medications is associated with decreased risk for alcohol-related falls, injuries, and poisonings in persons with OUD with and without co-occurring AUD.Design, setting, and participantsThis recurrent-event, case-control, cohort study used prescription claims from IBM MarketScan insurance databases from January 1, 2006, to December 31, 2016. The sample included persons aged 12 to 64 years in the US with an OUD diagnosis and taking OUD medication who had at least 1 alcohol-related admission. The unit of observation was person-day. Data analysis was performed from June 26 through September 28, 2020.ExposuresDays of active OUD medication prescriptions, with either agonist (ie, buprenorphine or methadone) or antagonist (ie, oral or extended-release naltrexone) treatments compared with days without OUD prescriptions.Main outcomes and measuresThe primary outcome was admission for any acute alcohol-related event defined by International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Conditional logistic regression was used to compare OUD medication use between days with and without an alcohol-related event. Stratified analyses were conducted between patients with OUD with and without a recent AUD diagnostic code.ResultsThere were 8 424 214 person-days of observation time among 13 335 participants who received OUD medications and experienced an alcohol-related admission (mean [SD] age, 33.1 [13.1] years; 5884 female participants [44.1%]). Agonist treatments (buprenorphine and methadone) were associated with reductions in the odds of any alcohol-related acute event compared with nontreatment days, with a 43% reduction for buprenorphine (odds ratio [OR], 0.57; 95% CI, 0.52-0.61) and a 66% reduction for methadone (OR, 0.34; 95% CI, 0.26-0.45). The antagonist treatment naltrexone was associated with reductions in alcohol-related acute events compared with nonmedication days, with a 37% reduction for extended-release naltrexone (OR, 0.63; 95% CI, 0.52-0.76) and a 16% reduction for oral naltrexone (OR, 0.84; 95% CI, 0.76-0.93). Naltrexone use was more prevalent among patients with OUD with recent AUD claims than their peers without AUD claims.Conclusions and relevanceThese findings suggest that OUD medication is associated with fewer admissions for alcohol-related acute events in patients with OUD with co-occurring AUD.

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

Publications

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

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