Public Release: 

Public feels more negative toward drug addicts than mentally ill

While both are treatable health conditions, stigma of drug addiction much more pronounced, seen as 'moral failing'

Johns Hopkins University Bloomberg School of Public Health

People are significantly more likely to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don't support insurance, housing, and employment policies that benefit those dependent on drugs, new Johns Hopkins Bloomberg School of Public Health research suggests.

A report on the findings, which appears in the October issue of the journal Psychiatric Services, suggests that society seems not to know whether to regard substance abuse as a treatable medical condition akin to diabetes or heart disease, or as a personal failing to be overcome.

"While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition," says study leader Colleen L. Barry, PhD, MPP, an associate professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. "In recent years, it has become more socially acceptable to talk publicly about one's struggles with mental illness. But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal."

Between Oct. 30 and Dec. 2, 2013, Barry and her colleagues surveyed a nationally representative sample of 709 participants about their attitudes toward either mental illness or drug addition. The questions centered on stigma, discrimination, treatment and public policy.

Not only did they find that respondents had significantly more negative opinions about those with drug addiction than those with mental illness, the researchers found much higher levels of public opposition to policies that might help drug addicts in their recovery.

Only 22 percent of respondents said they would be willing to work closely on a job with a person with drug addiction compared to 62 percent who said they would be willing to work with someone with mental illness. Sixty-four percent said that employers should be able to deny employment to people with a drug addiction compared to 25 percent with a mental illness. Forty-three percent were opposed to giving individuals addicted to drugs equivalent health insurance benefits to the public at-large, while only 21 percent were opposed to giving the same benefits to those with mental illness.

Respondents agreed on one question: Roughly three in 10 believe that recovery from either mental illness or drug addiction is impossible.

The researchers say that the stories of drug addiction portrayed in the media are often of street drug users in bad economic conditions rather than of those in the suburbs who have become addicted to prescription painkillers after struggling with chronic pain. Drug addicts who fail treatment are seen as "falling off the wagon," as opposed to people grappling with a chronic health condition that is hard to bring under control, they say. Missing, they say, are inspiring stories of people who, with effective treatment, are able to overcome addiction and live drug-free for many years.

Barry says once it would have been taboo for people to casually discuss the antidepressants they are taking, which is often the norm today. That kind of frank talk can do wonders in shaping public opinion, she says.

"The more shame associated with drug addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need," says another study author, Beth McGinty, PhD, MS, an assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. "If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction."

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"Stigma, Discrimination, Treatment Effectiveness, and Policy: Public Views About Drug Addiction and Mental Illness," was written by Colleen L. Barry, PhD, MPP; Emma E. McGinty, PHD, MS; Bernice A. Pescosolido, PhD; and Howard H. Goldman, MD, PhD.

The study was supported by grants from AIG Inc.; the National Institutes of Health's National Institute on Drug Abuse (R01 DA026414); the NIH's National Institute of Mental Health (1R01MH093414-01A1); the National Science Foundation and the College of Arts and Sciences, Indiana University.

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