Abstract
Death by suicide and opioid overdose has been associated with negative stigmatization. It is important to investigate whether a suicide death and a fatal opioid overdose share similar stigmatized reactions and how attitudes shape the public willingness to intervene in prevention and treatment efforts. Respondents were recruited for an online survey through convenience sampling and were randomly assigned to either respond to questions about suicide or opioid overdose death. Measurements included respondents’ attitudes toward suicide and opioid overdose decedents and their willingness to intervene. Results revealed that respondents were significantly more willing to intervene in a hypothetical case of a person at risk for suicide. There was greater stigmatization of individuals who died by opioid overdose compared to suicide. Considering that there remains little information about the complexities of stigma toward suicide and overdose, learning more about attitudes toward overdose deaths can also help us better understand how to change attitudes about individuals with substance use disorder.
Similar content being viewed by others
References
Ahmad, F. B., Rossen, L. M., Spencer, M. R., Warner, M., Sutton, P. (2018). Provisional drug overdose death counts. National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
Aldrich, R. S., Harrington, N. G., & Cerel, J. (2014). The Willingness to Intervene against Suicide questionnaire. Death Studies, 38(2), 1–9. https://doi.org/10.1080/07481187.2012.738763.
Angermeyer, M. C., & Matschinger, H. (1996). Social distance of the population toward psychiatric patients. Gesundheitswesen, 58, 18–23.
Angermeyer, M. C., & Matschinger, H. (1997). Social distance towards the mentally ill: Results of representative surveys in the Federal Republic of Germany. Psychological Medicine, 27, 131–141.
Angermeyer, M. C., & Matschinger, H. (2003). The stigma of mental illness: Effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatrica Scandinavica, 108(4), 304–309. https://doi.org/10.1034/j.1600-0447.2003.00150.x.
Athey, A. J., Beale, E. E., Overholser, J. C., Stockmeier, C. A., & Bagge, C. L. (2020). Acute stressors and clinical characteristics differentiate death by suicide, accident, or natural causes among illicit and prescription opiate users. Drug and Alcohol Dependence, 107847.
Batterham, P. J., Calear, A. L., & Christensen, H. (2013a). Correlates of suicide stigma and suicide literacy in the community. Suicide & Life-Threatening Behavior, 43(4), 406–417. https://doi.org/10.1111/sltb.12026.
Batterham, P., Calear, A., & Christensen, H. (2013b). The stigma of suicide scale: Psychometric properties and correlates of the stigma of suicide. Crisis, 34(1), 13–21. https://doi.org/10.1027/0227-5910/a000156.
Becker, E. (1973). The denial of death. New York: Academic Press.
Carpiniello, B., & Pinna, F. (2017). The reciprocal relationship between suicidality and stigma. Frontiers in Psychiatry, 8, 35. https://doi.org/10.3389/fpsyt.2017.00035.
Centers for Disease Control and Prevention. (n.d.). National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 3, 2018.
Cerel, J., Maple, M., DeVan Venne, J., Moore, M., Flaherty, C., & Brown, M. (2016). Exposure to suicide in the community: Prevalence and correlates in one US state. Public Health Reports, 131, 100–107. https://doi.org/10.1177/003335491613100116.
Connery, H. (2018). Silent no more: Suicide is epidemic. Harvard Health Publishing. Retrieved from https://blog.content.health.harvard.edu/blog/silent-no-more-suicide-is-epidemic/.
Connery, H. S., Taghian, N., Kim, J., Griffin, M., Rockett, I., Weiss, R. D., & Kathryn McHugh, R. (2019). Suicidal motivations reported by opioid overdose survivors: A cross-sectional study of adults with opioid use disorder. Drug and Alcohol Dependence, 205, 107612. https://doi.org/10.1016/j.drugalcdep.2019.107612.
Crump, M., McDonnell, J., & Gureckis, T. (2013). Evaluating Amazon’s Mechanical Turk as a tool for experimental behavioral research. PLoS ONE, 8(3), e57410.
Daley, D. C. (2013). Family and social aspects of substance use disorders and treatment. Journal of Food and Drug Analysis, 21(4), S73–S76. https://doi.org/10.1016/j.jfda.2013.09.038.
Dragisic, T., Dickov, A., Dickov, V., & Mijatovic, V. (2015). Drug addiction as risk for suicide attempts. Materia Socio-Medica, 27(3), 188–191. https://doi.org/10.5455/msm.2015.27.188-191.
Feigelman, W., Cerel, J., McIntosh, J., Brent, D., & Gutin, N. (2018). Suicide exposures and bereavement among American adults: Evidence from the 2016 General Social Survey. Journal of Affective Disorders, 227, 1–6. https://doi.org/10.1016/j.jad.2017.09.056.
Gatewood, A. K., Van Wert, M. J., Andrada, A. P., & Surkan, P. J. (2016). Academic physicians’ and medical students’ perceived barriers toward bystander administered naloxone as an overdose prevention strategy. Addictive Behaviors, 61, 40–46. https://doi.org/10.1016/j.addbeh.2016.05.013.
Goodyear, K., Haass-Koffler, C. L., & Chavanne, D. (2018). Opioid use and stigma: The role of gender, language and precipitating events. Drug and Alcohol Dependence, 185, 339–346. https://doi.org/10.1016/j.drugalcdep.2017.12.037.
Hazelden Foundation. (2009). Results from the fall 2008 national study of public attitudes toward addiction. Center City, MN.
Hedegaard, H., Warner, M., & Miniño, A. M. (2017). Drug overdose deaths in the United States, 1999–2016. NCHS data brief, no 294. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics. https://www.cdc.gov/nchs/data/databriefs/db294.pdfCdc-pdf.
Horton, J., Rand, J., & Zeckhauser, D. (2011). The online laboratory: Conducting experiments in a real labor market. Experimental Economics, 14(3), 399–425. https://doi.org/10.1007/s10683-011-9273-9.
Hosseinbor, M., Yassini Ardekani, S. M., Bakhshani, S., & Bakhshani, S. (2014). Emotional and social loneliness in individuals with and without substance dependence disorder. International Journal of High-risk Behaviors & Addiction, 3(3), e22688. https://doi.org/10.5812/ijhrba.22688.
Joszt, L. (2018). CDC data: Life expectancy decreases as deaths from suicide, drug overdose increase. American Journal of Managed Care (AJMC). Retrieved from https://www.ajmc.com/focus-of-the-week/cdc-data-life-expectancy-decreases-as-deaths-from-suicide-drug-overdose-increase.
Kegler, S. R., Stone, D. M., & Holland, K. M. (2017). Trends in suicide by level of urbanization — United States, 1999–2015. MMWR Morb Mortal Wkly Rep, 2017(66), 270–273. https://doi.org/10.15585/mmwr.mm6610a2.
Link, B., Phelan, J., Bresnahan, M., Stueve, A., & Pescosolido, B. (1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89(9), 1328–1333.
Mauri, M. C., Cerveri, G., Volonteri, L. S., Fiorentini, A., Colasanti, A., Manfré, S., et al. (2005). Parasuicide and drug self-poisoning: Analysis of the epidemiological and clinical variables of the patients admitted to the Poisoning Treatment Centre (CAV), Niguarda General Hospital, Milan. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 1(1), 5. https://doi.org/10.1186/1745-0179-1-5.
Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research (JCDR), 8(9), WE01–WWE4. https://doi.org/10.7860/JCDR/2014/10077.4828.
Paolacci, G., Chandler, J., & Ipeirotis, P. G. (2010). Running experiments on Amazon Mechanical Turk. Judgment and Decision making, 5(5), 411–419.
Pierce, M., Hayhurst, K., Bird, S. M., Hickman, M., Seddon, T., Dunn, G., & Millar, T. (2017). Insights into the link between drug use and criminality: Lifetime offending of criminally-active opiate users. Drug and Alcohol Dependence, 179, 309–316. https://doi.org/10.1016/j.drugalcdep.2017.07.024.
Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G. D., Serra, G., Girardi, P., Janiri, L., Tatarelli, R., Sher, L., & Lester, D. (2010). Suicidal behavior and alcohol abuse. International Journal of Environmental Research and Public Health, 7(4), 1392–1431. https://doi.org/10.3390/ijerph7041392.
Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., 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. https://doi.org/10.1093/alcalc/agq089.
Strickland, J. C., & Smith, M. A. (2013). The effects of social contact on drug use: Behavioral mechanisms controlling drug intake. Experimental and Clinical Psychopharmacology, 22(1), 23–34. https://doi.org/10.1037/a0034669.
Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/.
Taylor, R., Page, A., Wodak, A., Dudley, M., Munot, S., & Morrell, S. (2018). Confluence of suicide and drug overdose epidemics in young Australian males: Common causality? BMC Public Health, 18(1), 965. https://doi.org/10.1186/s12889-018-5875-x.
U.S Department of Justice, Office of Justice Programs. (2015). Drug offenders in federal prison: Estimates of characteristics based on linked data. Retrieved from https://www.bjs.gov/content/pub/pdf/dofp12.pdf.
Vandekerckhove, L. (1998). The decriminalization of suicide in 18th-century Europe. European Journal of Crime, Criminal Law and Criminal Justice, 6(3), 252–266.
Vivolo-Kantor, A. M., Seth, P., Gladden, R. M., Mattson, C. L., Baldwin, G. T., Kite-Powell, A., & Coletta, M. A. (2018). Vital signs: Trends in emergency department visits for suspected opioid overdoses—United States, July 2016–September 2017. Morbidity and Mortality Weekly Report, 67(9), 279–285.
Voss, W. D., Kaufman, E., O’Connor, S. S., Comtois, K. A., Connor, K. R., & Ries, R. K. (2013). Preventing addiction related suicide: A pilot study. Journal of Substance Abuse Treatment, 44(5), 565–569. https://doi.org/10.1016/j.jsat.2012.10.006.
Weinstock, C. P. (2018). Drug-overdose suicides may be going undetected. Reuters. Retrieved from https://www.reuters.com/article/us-health-suicide-drug-overdose/drug-overdose-suicides-may-be-going-undetected-idUSKBN1F0319.
Yang, L. H., Wong, L. Y., Grivel, M. M., & Hasin, D. S. (2017). Stigma and substance use disorders: An international phenomenon. Current Opinion in Psychiatry, 30(5), 378–388. https://doi.org/10.1097/YCO.0000000000000351.
Zhang, X., & Wu, L. T. (2014). Suicidal ideation and substance use among adolescents and young adults: A bidirectional relation? Drug and Alcohol Dependence, 142, 63–73. https://doi.org/10.1016/j.drugalcdep.2014.05.025.
Acknowledgements
This research was funded by the University of Kentucky College of Social Work.
Funding
The University of Kentucky College of Social Work provided funding for this study. Funding was used to compensate participants for their time in completing the study.
Author information
Authors and Affiliations
Contributions
The lead author, Athena Kheibari, was responsible for formulating the research questions, designing and implementing the study, and analyzing the data. Julie Cerel helps contribute to the study conceptualization and design, as well as to the manuscript preparation. Grant Victor helps in reviewing the data and contributed to the manuscript preparation.
Corresponding author
Ethics declarations
Ethical Approval
All study procedures involving human participants were approved by and in accordance with the ethical standards of the University of Kentucky Institutional Research Review Board. Before completing the study, participants were informed about the protocol and gave voluntary consent electronically.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kheibari, A., Cerel, J. & Victor, G. Comparing Attitudes Toward Stigmatized Deaths: Suicide and Opioid Overdose Deaths. Int J Ment Health Addiction 20, 2291–2305 (2022). https://doi.org/10.1007/s11469-021-00514-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11469-021-00514-1