Addiction Frameworks, Social Stigma, and NIMBY Syndrome: Examining Barriers to Responding to the Opioid Crisis

Scholars have argued that stigma of opioid use disorder (OUD) is a significant barrier to implementing evidence-based responses to the opioid crisis, including the use of medications for opioid use disorder (MOUD). They have also documented a relationship between addiction frameworks and support for punitive responses to substance use. Using a representative sample of Pennsylvania residents (N = 1,033), the current study synthesizes this literature by empirically examining the relationship between addiction frameworks, opioid-related stigma, and policy-related attitudes (i.e., NIMBY syndrome, support for punitive treatment of OUD, and support for employment discrimination against individuals prescribed MOUD). Results show that support for the disease model of addiction was negatively associated with endorsing NIMBY syndrome for opioid-treatment centers, support for punitive treatment of OUD, and support for employment discrimination against individuals prescribed MOUD; however, these relationships were fully mediated by opioid-related stigma, such that support for the disease model of addiction impacted outcome measures only indirectly through opioid-related stigma. Policy implications are discussed within.