Contact reduces substance use stigma through bad character attributions, especially for U.S. health care professionals.

Abstract

People with substance use disorders (SUDs) are faced with pervasive stigma. Education-based interventions tend to emphasize biological causes of dependency; however, health care professionals still stigmatize people who use substances despite being more knowledgeable about biological causes. There may be an important moderating role of personal contact since health care professionals may treat people in the throes of dependency. We tested how substance use stigma may be explained by causal attributions, working in health care, and personal contact. A nationally representative sample of the U.S. general population (N = 6,812) was collected with targeted oversampling of health care professionals (N = 788). Using a vignette paradigm, desire for social distance was measured along with causal attributions and contact. Health care professionals were no less stigmatizing than the general population. However, attributing substance dependency to bad character was robustly associated with stigma, but these beliefs were moderated by the interaction between working in health care and contact. Mediation decomposition confirmed that contact transmitted its effect by lowering bad character attributions, and this mediation was significantly stronger for health care professionals. Health care professionals and the general population may hold similar levels of stigma when accounting for attributions, and personal contact plays an important role. We discuss the implications of these results for stigma-reduction campaigns and emphasize deconstructing personal culpability narratives surrounding substance use disorders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).