Who Deserved Help? A Vignette Experiment of Fentanyl Overdose Victims' Perceived Blameworthiness
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Date
2023-05
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The Ohio State University
Abstract
The United States is facing a drug overdose crisis. Stigma, blame, and exclusionary attitudes towards people who use drugs are key roadblocks to implementing solutions. Prior studies of these negative attitudes have focused narrowly on people with substance use disorder and a small set of demographic characteristics. However, as unintentional fentanyl overdoses become a major driver of drug-related deaths, overdoses now involve a broader range of victims and more complex situations. Consequently, the nature and magnitude of these attitudes must be reassessed. For this thesis study, I constructed fictional obituary vignettes where decedent characteristics (race, gender, age, history of substance use, drug of use, and socioeconomic status) were randomly varied in a conjoint design. A national sample of American adults (n=1,432) were shown two of these obituaries and chose one individual to endorse for each of several outcomes, including attributions of blame, referrals to interventions, and public sympathy. I find that age and history of substance use have the strongest influence on all three outcomes. Additional factors, such as race, gender, and drug of use, also impacted these attitudes. These results suggest that attitudes towards fentanyl overdose victims hinge on a multifaceted set of demographic characteristics that lead to patterned disparities in who is seen as worthy of help.
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Keywords
stigma, fentanyl, public opinion, drug overdose