Correlates of public support toward federal funding for harm reduction strategies

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RESEARCH

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Correlates of public support toward federal funding for harm reduction strategies Magdalena Kulesza1,2*, Bethany A. Teachman3, Alexandra J. Werntz3, Melissa L. Gasser1 and Kristen P. Lindgren1

Abstract Background: Historically, US federal policy has not supported harm reduction interventions, such as safe injection facilities (SIFs) and needle and syringe programs (NSPs), which can reduce the burden associated with injection drug use. Given recent increases in abuse of both legal and illegal opioids, there has been a renewed debate about effective ways to address this problem. The current study (1) assessed participants’ support for SIFs and NSPs, and (2) evaluated several demographic factors (e.g., age, gender, race, education, political ideology, and religiosity) and individual differences in stigmatizing beliefs about people who inject drugs (PWID) that might relate to support for these interventions. Methods: U.S. adults (N = 899) completed a web-based study that assessed self-reported support for NSPs and SIFs, and stigma about PWID. Results: The majority of participants were at least somewhat supportive of both NSPs and SIFs. Regression analyses indicated greater support for NSPs and SIFs was predicted by more liberal political ideology, more agreement that PWID deserve help rather than punishment, older age, and male gender. Also, participants who endorsed lower stigma about PWID were more supportive of NSPs and SIFs. Race, religiosity, and education did not predict support for NSPs and SIFs. Conclusions: Most participants tended to report support for harm reduction strategies. Age, political ideology, and individual differences in stigmatizing beliefs about PWID were significantly associated with support. Given the potential malleability of stigmatizing beliefs, efforts that seek to shift stigma about PWID could have important implications for public policy towards harm reduction strategies for PWID. Keywords: Public stigma, Intravenous drug use, Harm reduction, Safe injection facilities, Needle and syringe programs

Background Injection drug use is associated with significant societal costs, and both opiate use and related deaths are increasing nationwide [5]. Although harm reduction strategies, such as needle and syringe programs (NSPs) and safe injection facilities (SIFs), have been shown to be effective at reducing negative consequences of drug use [23, 41, 42], these strategies are not currently part of federal drug control policy in the U.S., likely due to political, legal, and moral objections [1, 35], as well as stigma, and perception of drug use as a criminal behavior, rather than a health * Correspondence: [email protected] 1 Department of Psychiatry, University of Washington, 1100 NE 45th Street, Seattle, WA 98105, USA 2 RAND Corporation, 1776 Main St, Santa Monica, CA 90407, USA Full list of author information is available at the end of the article

problem [33]. Still, a number of U.S. states provide funding for some form of harm reduction interventions, and there is ren