Inaugural survey reveals pervasive discrimination by public, employers, and health care workers is making substance use disorder more difficult to address
Today, Shatterproof and its collaborator The Hartford published the largest, most expansive survey ever fielded on addiction stigma of nearly 8,000 U.S. residents. The findings are striking. More than three-quarters of the American public believe that a substance use disorder (SUD) is not a chronic medical illness and over half of respondents hold the belief that SUDs are caused by bad character or lack of moral strength, according to the national research.
The Shatterproof Addiction Stigma Index, a first-of-its-kind measurement tool, was designed to assess attitudes about substance use and people who use substances. It used more than 50 validated stigma measures to gauge perceptions of those with a SUD, including the degree to which they have internalized this exclusion. The Index is designed to track progress regularly and hold our nation accountable for continual improvement.
The lack of understanding about addiction by the general public creates a desire for social distance. According to the survey, nearly half (45%) of the public is unwilling to live next to or be close friends with someone with a SUD. Similarly, 45.8% of respondents don't want a person in recovery marrying into their family – highlighting how these beliefs entrench deep feelings of exclusion and shame for individuals with a SUD throughout their lives, regardless of their recovery status.
“What’s at stake is real. For millions of people across the country, fighting pervasive stigma is a matter of survival,” said Gary Mendell, CEO of Shatterproof. “We must change the way our institutions operate, the way we view our friends and neighbors, and how those with a SUD view themselves. We must end discrimination, strengthen the road to recovery, and offer hope of a bright future. And measuring our progress is essential.”
Dr. Melissa Anderson, MD, PharmD, a Shatterproof Ambassador from Kentucky and a person in long-term recovery, has experienced stigma in both the health care and workplace settings. Following a severe dog bite incident, she found herself as a patient in the hospital system where she’d previously been employed as both a pharmacist and a resident physician. “Former co-workers greeted me with jeers, joking that the ‘doctor-turned-junkie’ was back. During my 8-hour ER stay, I did not receive the standard of care for my injuries - neither antibiotics nor analgesics were administered, after I requested non-opioid agents, despite standard facility protocols and the easily-observed severity of my injuries,” said Dr. Anderson. “It was made abundantly clear from both their actions and language team that this health care team felt the disease of addiction, even one in recovery, made me an individual less deserving of compassion and care. That was July 2015 and I have not been a formal recipient of health care since.”
Nearly half (44%) of health care professionals surveyed endorsed the harmful belief that medications for opioid use disorder (MOUD) is substituting one drug for another. This is compared to the about 41% of the public that expressed the same belief. Moreover, one in four health care professionals do not agree that more providers should offer MOUD to increase accessibility.
“The work to end addiction stigma is far from over, and we are proud to partner with Shatterproof on establishing this important research that will drive future public policies and workplace practices,” said Christopher J. Swift, chairman and CEO of The Hartford, a leading workers’ compensation and disability insurer and founding partner of Shatterproof. “We believe efforts involving all levels of government, the business community, and neighborhood organizations are necessary to end the ongoing addiction crisis, create open and inclusive cultures, and break down stigma that impedes human achievement.”
Nearly a million people have been lost to addiction in the last two decades and in 2020 alone, more than 93,000 Americans died of an overdose, representing the most overdoses ever recorded. More than 20 million American adults suffer from the disease of addiction per year. Addiction is a treatable disease, but due to stigma most people do not seek the help they need and equally tragically, internalize feelings of shame and lose hope that they can recover and lead healthy, full lives.
Creation of the Index was supported by Ipsos alongside Dr. Brea Perry and Dr. Anne Krendl from Indiana University.
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About Shatterproof
Shatterproof is a national nonprofit organization dedicated to reversing the addiction crisis in the United States. Shatterproof harnesses the models of business, the rigor of science and the power of a national movement to create change and save lives through three pillars of work: revolutionizing the addiction treatment system, breaking down addiction-related stigmas and supporting and empowering our communities. To learn more visit www.Shatterproof.org
