More than half of Philadelphians surveyed by the Pew Charitable Trusts this spring said that they believe people with opioid addiction brought their condition upon themselves, and that addiction is not like contracting a disease.
In a poll of 1,303 city residents conducted between March and May, 58% told Pew researchers they believed opioid addiction was something people brought on themselves, while 42% said the condition is a disease.
“We spent a lot of time on this question,” said Larry Eichel, project director of Pew’s research initiatives. “Do Philadelphians think that [people with addiction] are people who put themselves in that position? Is it something they have control over or not?”
Experts have long agreed that addiction is a chronic, relapsing disease of the brain, Eichel noted in a report on the survey, albeit one whose origins are complex.
Some research suggests that among people in active addiction, presenting addiction as a disease might make people feel like it’s a fixed state, not easily treatable, and that reframing addiction and drug use as conditions with complicated roots might motivate people to seek treatment. But treating addiction as simply a moral failing only increases the stigma against people who use drugs, experts say.
“The view that people who become dependent on opioids are somehow to blame has proven to be a barrier” to expanding access to medications to treat opioid addiction, Eichel noted in his report, citing a March report from the National Academies of Sciences, Engineering and Medicine.
Philadelphians’ views on the roots of addiction, though, don’t necessarily preclude their sympathy for people struggling with it. Seventy percent of the respondents to Pew’s survey said they had “some" or “a lot” of sympathy for people in addiction. Family members of people in addiction were the most likely to express sympathy, but only 49% of those family members said they viewed the condition as a disease.
Views on addiction and its roots varied by education, race, and neighborhood, the survey found. People with college degrees were more likely to view addiction as a disease. Blacks and Hispanics were more likely to view it as something people bring upon themselves. White survey respondents were split on the question.
In the river wards, which include Kensington and other neighborhoods dealing with the worst of Philadelphia’s opioid crisis and some of the highest fatal overdose numbers in the city, just 27% of survey respondents said they viewed addiction as a disease. However, 65% of survey respondents from the river wards said they had “some” or “a lot” of sympathy for people in opioid addiction.
Jose Benitez, executive director of Prevention Point, the Kensington-based public health organization for people in addiction, said he found the survey results saddening.
“We still have a lot to learn about this field, and a lot to learn about how the chemicals [in drugs] change people. [Addiction] is really about biology, and I just don’t think that we’ve done a good job of putting the science out there,” he said.
Still, he added, “overwhelmingly, Philadelphians have empathy for people who are in the midst of an opioid use disorder. I think if there was anything encouraging, it was that.”
Eichel said he hoped the survey could help inform discussions on addiction and drug policy in Philadelphia.
Because a stigma can keep people from seeking treatment, he said, Pew staffers thought the issue was important to research — especially because Philadelphia officials and insurance providers like Independence Blue Cross have created programs aimed at dispelling stigma and encouraging people to seek medication-assisted treatment.