Abstract

BackgroundWe investigated whether beliefs about addiction being a ‘disease’ or ‘brain disease’, and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction.MethodsData were collected as part of the 2012 Queensland Social Survey, a computer assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted males, one who was addicted to heroin and the other addicted to alcohol. Participants were then asked a series of questions for both characters.ResultsThere was widespread support for all treatment modalities (alcohol: 80.8-98.0%, heroin: 89.9-97.2%). There was less support for coerced treatment for alcohol than heroin addiction (alcohol: 41%, heroin: 71%, χ2 = 273.90, p < 0.001). Being 35 years of age or older (alcohol: OR = 0.58 (0.37-0.91), heroin: OR = 0.49 (0.28-0.85)) and having 15 or more years of education (alcohol: OR = 0.60 (0.44-0.81), heroin: 0.55 (0.40-0.75)) predicted less support for coerced treatment. 31.7% of respondents agreed heroin use should be punished by imprisonment and being 35 years of age or older (OR = 0.51 (0.33-0.80)) predicted lack of support. The sample agreed that an alcohol or heroin dependent person would suffer career damage (alcohol: 96.2%, heroin: 98.9%), marriage breakdown (alcohol: 92.2%, heroin: 97.3%) and get in trouble with the law (alcohol: 92.3%, heroin: 98.9%). Respondents expressed more comfort with encountering alcohol rather than heroin addicted persons in the workplace or at a dinner party. Beliefs that addiction was a ‘brain disease’ or a ‘disease’ did not predict any of these attitudes. Beliefs about addiction aetiology were inconsistent predictors of outcomes measured.ConclusionsAge and educational attainment were the most consistent predictors of stigmatising beliefs and beliefs about coercion and punishment. Beliefs that addiction is a ‘disease’ or a ‘brain disease’ were not associated with an overall reduction in beliefs about stigma, coercion or punishment. Beliefs in different causes of addiction were not consistent predictors of beliefs about stigma, coercion or punishment.

Highlights

  • We investigated whether beliefs about addiction being a ‘disease’ or ‘brain disease’, and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction

  • Participants were most likely to agree that a person should speak to family, friends, or attend a support group like Alcoholics Anonymous or Narcotics Anonymous (98% for alcohol, 97.2% for heroin)

  • Beliefs about coerced treatment of addiction There was significantly greater support for forcing Peter into treatment for his heroin addiction (71%) than for forcing John into treatment for his alcohol addiction (41%) (χ2 = 273.90, p < 0.001)

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Summary

Introduction

We investigated whether beliefs about addiction being a ‘disease’ or ‘brain disease’, and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction. Neuroscience research on the effects of chronic addictive drug use on brain function has been used to argue that addiction is a chronic relapsing ‘brain disease’ [1,2]. The brain disease model holds that the brain changes associated with repeated drug use impair autonomy and restrict addicted persons’ ability to freely refrain from using drugs [3]. The implications of this model for how addicted individuals are viewed and treated are hotly contested. An optimistic view of the brain disease model suggests that it provides a rationale for offering treatment to drug addicted offenders rather than incarcerating them for crimes related to their addiction (e.g. drug possession, crimes committed in order to obtain drugs) [4]

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