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Abstract

Prior work has suggested that provider-based stigma of substance use disorders may be one barrier to fighting the opioid epidemic. However, to date, provider-based stigma has been afforded little attention in the context of the criminal justice system. The goal of the current study was to extend this line of research by examining the impact of provider-based stigma toward opioid using persons to beliefs about help that should be provided to persons experiencing an overdose among a sample of 208 police officers working in departments in the Northeastern Region of the United States. In addition, this study explores the relationship between provider-based stigma and the anticipated on-duty behavioral responses to opioid overdoses. Results from multivariable analyses indicate that certain dimensions of social stigma are significantly related to officers’ perceptions of help in varying directions, along with officers’ experiences with naloxone administration and departmental policy pertaining to the use of naloxone.

Keywords

stigma and responses to drug users police perceptions and willingness to help

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References

Ashford

R. D.

Brown

Curtis

(2019). Expanding language choices to reduce stigma: A Delphi Study of positive and negative terms in substance use and recovery. Health Education, 119(1), 51–62. https://doi.org/10.1108/HE-03-2018-0017

Azur

M. J.

Stuart

E. A.

Frangakis

Leaf

P. J.

(2011). Multiple imputation by chained equations: What is it and how does it work? International Journal of Methods in Psychiatric Research, 20(1), 40–49.

Bachman

R. D.

Schutt

R. K.

(2015). Fundamentals of research in criminology and criminal justice (3rd ed.). SAGE.

Bahora

Hanafi

Chien

Compton

(2008). Preliminary evidence of effects of Crisis Intervention Team training on self-efficacy and social distance. Administration and Policy in Mental Health, 35, 159–167.

Banta-Green

Beletsky

Schoeppe

Coffin

Kuszler

(2013). Police officers’ and paramedics’ experiences with overdose and their knowledge and opinions of Washington state’s drug overdose-naloxone-Good Samaritan law. Journal of Urban Health-Bulletin of the New York Academy of Medicine, 90(6), 1102–1111.

Barry

C. L.

McGinty

E. E.

Pescosolido

B. A.

Goldman

H. H.

(2014). Stigma, discrimination, treatment effectiveness, and policy: Public views about drug addiction and mental illness. Psychiatric Services, 65(10), 1269–1272.

Beletsky

Macalino

G. E.

Burris

(2005). Attitudes of police officers towards syringe access, occupational needle-sticks, and drug use: A qualitative study of one city police department in the United States. International Journal of Drug Policy, 16(4), 267–274.

Boyd

J. E.

Katz

E. P.

Link

B. G.

Phelan

J. C.

(2010). The relationship of multiple aspects of stigma and personal contact with someone hospitalized for mental illness, in a nationally representative sample. Social Psychiatry and Psychiatric Epidemiology, 45(11), 1063–1070.

Briggs

S. R.

Cheek

J. M.

(1986). The role of factor analysis in the development and evaluation of personality scales. Journal of Personality, 54(1), 106–148.

10.

Britt

T. W.

Greene-Shortridge

T. M.

Brink

Nguyen

Q. B.

Rath

Cox

A. L.

Hoge

C. W.

Castro

C. A.

(2008). Perceived stigma and barriers to care for psychological treatment: Implications for reactions to stressors in different contexts. Journal of Social and Clinical Psychology, 27(4), 317–335.

11.

Brown

S. A.

(2011). Standardized measures for substance use stigma. Drug and Alcohol Dependence, 116(1), 137–141.

12.

Bureau of Justice Assistance. (2019). Naloxone toolkit content. https://bjatta.bja.ojp.gov/tools/naloxone/Acquiring%2BNaloxone

13.

Bureau of Justice Statistics. (2017). Drug use, dependence, and abuse among state prisoners and jail inmates, 2007-2009. https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf

14.

Burris

Beletsky

Castagna

C. L.

Coyle

Crowe

McLaughlin

J. M.

(2009). Stopping an invisible epidemic: Legal issues in the provision of naloxone to prevent opioid overdose. Drexel Law Review, 1(2), 273–340.

15.

Capitanio

J. P.

Herek

G. M.

(1999). AIDS-related stigma and attitudes towards injecting drug users among Black and White Americans. American Behavioral Scientist, 42, 1144–1157.

16.

Centers for Disease Control and Prevention. (2020). Opioid overdose: Understanding the epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html

17.

Chan

K. Y.

Yang

Zhang

K.-L.

Reidpath

D. D.

(2007). Disentangling the stigma of HIV/AIDS from the stigmas of drugs use, commercial sex and commercial blood donation—A factorial survey of medical students in China. BMC Public Health, 7, Article 280. http://doi.org/10.1186/1471-2458-7-280

18.

Clement

Lassman

Barley

Evans-Lacko

Williams

Yamaguchi

Thornicroft

(2013). Mass media interventions for reducing mental health-related stigma. The Cochrane Database of Systematic Reviews, 23(7), Article CD009453.

19.

Coleman

Walker

J. S.

Lee

Friesen

B. J.

Squire

P. N.

(2009). Children’s beliefs about causes of childhood depression and ADHD: A study of stigmatization. Psychiatric Services, 60(7), 950–957.

20.

Comartin

E. B.

Swanson

Kubiak

(2019). Mental health crisis location and police transportation decisions: The impact of Crisis Intervention Team training on crisis center utilization. Journal of Contemporary Criminal Justice, 35(2), 241–260.

21.

Committee on the Science of Changing Behavioral Health Social Norms; Board on Behavioral, Cognitive, and Sensory Sciences; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine. (2016). Ending discrimination against people with mental and substance use disorders: The evidence for stigma change. Washington (DC): National Academies Press (US); Aug 3. PMID: 27631043.

22.

Compton

Bakeman

Broussard

Hnakerson-Dyson

Husbands

Krishan

(2014). The police-based Crisis Intervention Team (CIT) model: Effects on officers’ knowledge, attitudes, and skills. Psychiatric Services, 65(4), 517–522.

23.

Cook

J. E.

Purdie-Vaughns

Meyer

I. H.

Busch

J. T. A.

(2014). Intervening within and across levels: A multilevel approach to stigma and public health. Social Science & Medicine, 103, 101–109.

24.

Corrigan

P. W.

Kuwabara

S. A.

O’Shaughnessy

(2009). The public stigma of mental illness and drug addiction: Findings from a stratified random sample. Journal of Social Work, 9(2), 139–147.

25.

Corrigan

P. W.

Morris

S. B.

Michaels

P. J.

Rafacz

J. D.

Rüsch

(2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973.

26.

Crisp

A. H.

Gelder

M. G.

Rix

Meltzer

H. I.

Rowlands

O. J.

(2000). Stigmatization of people with mental illness. British Journal of Psychiatry, 177, 4–7.

27.

Davis

C. S.

Carr

Southwell

J. K.

Beletsky

(2015). Engaging law enforcement in overdose reversal initiatives: Authorization and liability for naloxone administration. American Journal of Public Health, 105(8), 1530–1537.

28.

Davis

C. S.

Ruiz

Glynn

Picariello

Walley

(2014). Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts. American Journal of Public Health, 104(8), E7–E9.

29.

Ding

Landon

B. E.

Wilson

I. B.

Wong

M. D.

Shapiro

M. F.

Cleary

P. D.

(2005). Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Archives of Internal Medicine, 165(6), 618–623.

30.

Drug Enforcement Administration. (2019). Drug-related overdose deaths in Pennsylvania, 2018. https://www.dea.gov/sites/default/files/2019-10/PRB%20FINAL%20–%20BUL-132-19%20Drug-Related%20Overdose%20Deaths%20in%20Pennsylvania%2C%202018.pdf

31.

Federal Bureau of Investigation. (2018). Police employee data. https://ucr.fbi.gov/crime-in-the-u.s/2017/crime-in-the-u.s.-2017/topic-pages/police-employee-data

32.

Federal Bureau of Investigation. (2020). Crime in the U.S., 2019. National Institute of Justice. https://ucr.fbi.gov/crime-in-the-u.s/2019/crime-in-the-u.s.-2019/topic-pages/tables/table-29

33.

Formica

Apsler

Wilkins

Ruiz

Reilly

Walley

(2018). Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts. International Journal of Drug Policy, 54, 43–50.

34.

Franz

Carter

Leiner

Bergner

Thompson

Compton

(2010). Stigma and treatment delay in first-episode psychosis: A grounded theory study. Early Intervention in Psychiatry, 4(1), 47–56.

35.

Goodison

S. E.

Vermeer

M. J.

Barnum

J. D.

Woods

Jackson

B. A.

(2019). Law enforcement efforts to fight the opioid crisis: Convening police leaders, multidisciplinary partners, and researchers to identify promising practices and to inform a research agenda. https://www.rand.org/content/dam/rand/pubs/research_reports/RR3000/RR3064/RAND_RR3064.pdf

36.

Green

Zaller

Palacios

W. R.

Bowman

S. E.

Ray

Heimer

Case

(2013). Law enforcement attitudes toward overdose prevention and response. Drug and Alcohol Dependence, 133(2), 677–684.

37.

Griffiths

K. M.

Carron-Arthur

Parsons

Reid

(2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry, 13(2), 161–175.

38.

Hadley

(2019). Deflecting opioid sufferers from the justice system “Can save lives,” experts say. Retrieved from https://thecrimereport.org/2019/02/26/deflecting-opioid-sufferers-from-the-justice-system-can-save-lives-experts-say/

39.

Hanafi

Bahora

Demir

Compton

(2008). Incorporating Crisis Intervention Team knowledge and skills into the daily work of police officers: A focus group study. Community Mental Health Journal, 44, 427–432.

40.

Haug

Bielenberg

Linder

Lembke

(2016). Assessment of provider attitudes toward #naloxone on Twitter. Substance Abuse, 37(1), 35–41.

41.

Henderson

Stacey

C. L.

Dohan

(2008). Social stigma and the dilemmas of providing care to substance users in a safety-net emergency department. Journal of Health Care for the Poor and Underserved, 19(4), 1336–1349.

42.

Jacoby

J. L.

Crowley

L. M.

Cannon

R. D.

Weaver

K. D.

Henry-Morrow

T. K.

Henry

K. A.

…McCarthy

J. F.

(2020). Pennsylvania law enforcement use of Narcan. The American Journal of Emergency Medicine, 38(9), 1944–1946. https://doi.org/10.1016/j.ajem.2020.01.051

43.

Janulis

Ferrari

J. R.

Fowler

(2013). Understanding public stigma toward substance dependence: Public stigma toward dependence. Journal of Applied Social Psychology, 43(5), 1065–1072.

44.

Kruis

N. E.

Choi

(2020). Exploring social stigma toward opioid and heroin users among students enrolled in criminology, nursing, and EMT/paramedic courses. Journal of Criminal Justice Education, 31(3), 319–340. https://doi.org/10.1080/10511253.2020.1736112

45.

Kruis

N. E.

Choi

Donohue

R. H.

(2020). Police officers, stigma, and the opioid epidemic. International Journal of Police Science & Management, 1461355720962524.

46.

Kvaale

E. P.

Gottdiener

W. H.

Haslam

(2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science & Medicine, 96, 95–103.

47.

Link

B. G.

Cullen

F. T.

Frank

Wozniak

J. F.

(1987). The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92(6), 1461–1500.

48.

Link

B. G.

Phelan

J. C.

Bresnahan

Stueve

Pescosolido

B. A.

(1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89(9), 1328–1333.

49.

Lloyd

(2013). The stigmatization of problem drug users: A narrative literature review. Drugs: Education, Prevention and Policy, 20(2), 85–95.

50.

Lowder

E. M.

Lawson

S. C.

O’Donnell

Sightes

Ray

B. R.

(2020). Two-year outcomes following naloxone administration by police officers or emergency medical services personnel. Criminology & Public Policy, 19, 1019–1040. https://doi.org/10.1111/1745-9133.12509

51.

Lurigio

A. J.

Andrus

Scott

C. K.

(2018). The opioid epidemic and the role of law enforcement officers in saving lives. Victims & Offenders, 13(8), 1055–1076.

52.

McCreaddie

Lyons

Watt

Ewing

Croft

Smith

Tocher

(2010). Routines and rituals: A grounded theory of the pain management of drug users in acute care settings. Journal of Clinical Nursing, 19(19–20), 2730–2740.

53.

Mehta

Clement

Marcus

Stona

Bezborodovs

Evans-Lacko

…Thornicroft

(2015). Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: Systematic review. The British Journal of Psychiatry: The Journal of Mental Science, 207(5), 377–384.

54.

Moreau

(2010). What is discrimination? Philosophy & Public Affairs, 38(2), 143–179.

55.

Murphy

Russell

(2020). Police officers’ views of naloxone and drug treatment: Does greater overdose response lead to more negativity? Journal of Drug Issues, 50(4), 455–471.

56.

National Institute of Justice. (2019). Law enforcement looks to research to help fight the opioid crisis. https://nij.ojp.gov/topics/articles/law-enforcement-looks-research-help-fight-opioid-crisis

57.

National Institute on Drug Abuse. (2020). Criminal justice drugfacts. https://www.drugabuse.gov/publications/drugfacts/criminal-justice

58.

National Institute on Drug Abuse. (2018a). Heroin. https://www.drugabuse.gov/publications/drugfacts/heroin

59.

National Institute on Drug Abuse. (2018b). Opioid overdose reversal with naloxone (Naloxone, Evzio). https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-reversal-naloxone-narcan-evzio

60.

National Institute on Drug Abuse. (2018c). Overdose death rates. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

61.

North Carolina Harm Reduction Coalition. (2019a). North Carolina naloxone law enforcement officer policy. http://www.nchrc.org/law-enforcement/sample-law-enforcement-naloxone-policy/

62.

North Carolina Harm Reduction Coalition. (2019b). US law enforcement who carry naloxone. http://www.nchrc.org/law-enforcement/us-law-enforcement-who-carry-naloxone/

63.

Ormston

Bradshaw

Anderson

(2010). Scottish social attitudes survey 2009: Public attitudes to drugs and drug use in Scotland. Scottish Government Social Research.

64.

Peckover

Chidlaw

R. G.

(2007). Too frightened to care? Accounts by district nurses working with clients who misuse substances. Health & Social Care in the Community, 15(3), 238–245.

65.

Pescosolido

B. A.

Martin

J. K.

Long

J. S.

Medina

T. R.

Phelan

J. C.

Link

B. G.

(2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry, 167(11), 1321–1330.

66.

Pescosolido

Martin

(2015). The stigma complex. Annual Review of Sociology, 41, 87–116.

67.

President’s Task Force on 21st Century Policing. (2015). Final report of the President’s task force on 21st century policing. Office of Community Oriented Policing Services. https://cops.usdoj.gov/pdf/taskforce/taskforce_finalreport.pdf

68.

Rahr

Rice

S. K.

(2015). From warriors to guardians: Recommitting American police culture to democratic ideals—New perspectives in policing bulletin. U.S. Department of Justice, National Institute of Justice. https://www.ncjrs.gov/pdffiles1/nij/248654.pdf

69.

Ray

O’Donnell

Kahre

(2015). Police officer attitudes towards intranasal naloxone training. Drug and Alcohol Dependence, 146, 107–110.

70.

Raymond

M. R.

Roberts

D. M.

(1987). A comparison of methods for treating incomplete data in selection research. Educational and Psychological Measurement, 47(1), 13–26.

71.

Rees

Sabia

Argys

Dhaval

(2017). With a little help from my friends: The effects of naloxone access and Good Samaritan laws on opioid-related deaths. http://www.nber.org/papers/w23171

72.

Remler

D. K.

Van Ryzin

G. G.

(2015). Research methods in practice: Strategies for description and causation. SAGE.

73.

Room

(2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review, 24(2), 143–155.

74.

Sampogna

Bakolis

Evans-Lacko

Robinson

Thornicroft

Henderson

(2017). The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009–2014 time to change programme. European Psychiatry, 40, 116–122.

75.

Saunders

Metcalf

Walsh

Moore

Meier

McLeman

…Marsh

(2019). “You can see those concentric rings going out”: Emergency personnel’s experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire. Drug and Alcohol Dependence, 204, 1–10.

76.

Schomerus

Lucht

Holzinger

Matschinger

Carta

M. G.

Angermeyer

M. C.

(2011). The stigma of alcohol dependence compared with other mental disorders: A review of population studies. Alcohol and Alcoholism, 46(2), 105–112.

77.

Seo

Kim

Kruis

N. E.

(2021). Variation across police response models for handling encounters with people suffering from mental illnesses: A systematic review and meta-analysis. Journal of Criminal Justice, 72, 101752. https://doi.org/10.1016/j.jcrimjus.2020.101752

78.

Stangor

Crandall

(2013). Stereotyping and prejudice (1st ed.). Psychology Press.

79.

Stuber

Kronebusch

(2004). Stigma and other determinants of participation in TANF and Medicaid. Journal of Policy Analysis and Management, 23(3), 509–530.

80.

Thornicroft

Mehta

Clement

Evans-Lacko

Doherty

Rose

Henderson

(2015). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123–1132.

81.

Wagner

K. D.

Bovet

L. J.

Haynes

Joshua

Davidson

P. J.

(2016). Training law enforcement to respond to opioid overdose with naloxone: Impact on knowledge, attitudes, and interactions with community members. Drug and Alcohol Dependence, 165, 22–28.

82.

Walley

A. Y.

Xuan

Hackman

H. H.

Quinn

Doe-Simkins

Sorensen-Alawad

…Ozonoff

(2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. BMJ: British Medical Journal, 346, Article f174. https://doi.org/10.1136/bmj.f174

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A Preliminary Assessment of Stigma in Law Enforcement Officers’ Responses to Opioid Overdoses

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