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​Americans Recognize the Growing Problem of Opioid Addiction

Issue Brief

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© 2017 AP Photo/Tony Talbot

More Americans see opioid addiction as a significant issue for their community today than in 2016, according to a recent survey by The Associated Press-NORC Center for Public Affairs Research. Forty-three percent of Americans say the use of prescription pain drugs is a serious problem in their community, up from 33 percent two years ago. Additionally, 37 percent see heroin as a serious concern locally, up from 32 percent in 2016.

According to the Centers for Disease Control and Prevention (CDC), the opioid epidemic1 in the United States is spreading across the country and affecting Americans of all kinds, with two-thirds of drug overdose deaths in 2016 involving a prescription or illegal opioid.2

Moving from the community into the home, a majority of Americans report having experience with substance misuse of various types, and 13 percent have had a relative or close friend die from an opioid overdose.

Although 53 percent of the public sees prescription drug addiction as a disease, many regard addiction as a behavioral failing instead. Forty-four percent say opioid addiction indicates a lack of willpower or discipline; 32 percent say it is caused by a character defect or bad parenting. And less than 1 in 5 Americans are willing to associate closely with someone who is addicted to prescription drugs as a friend, colleague, or neighbor.

Certain types of opioid messaging are prevalent on social media. Of the 74 percent of adults who report using Facebook, 41 percent say they have seen messages about the opioid epidemic or death from overdoses. Fewer users of Twitter, Instagram, or Snapchat have seen messages about the problem of opioids. Fewer than 1 in 10 users of any platform have seen offers to purchase opioids on social media platforms.

The federal government will spend a record $4.6 billion this year to tackle the opioid epidemic,3 allocating funding across agencies to help states and local governments in efforts toward prevention, treatment, and law enforcement initiatives. And most Americans agree that their communities need the funding, saying local agencies aren’t doing enough to tackle the epidemic, according to the survey.

The nationwide survey of 1,054 adults used AmeriSpeak®, the probability-based panel of NORC at the University of Chicago. Interviews were conducted between March 14 and 19, 2018, online and using landlines and cell phones. The margin of sampling error is +/- 4.1 percentage points.

MANY AMERICANS SEE THE GROWING OPIOID CRISIS IN THEIR COMMUNITIES.

Data analyzed by the CDC indicate that the opioid overdose epidemic in the United States continues to worsen. Drug overdoses killed 63,632 Americans in 2016, and 66 percent of those deaths involved an opioid.4 In addition, emergency room visits for suspected opioid overdoses increased by 30 percent between July 2016 and September 2017.5  

Many Americans see the problem in their communities. Forty-three percent of Americans say the use of opioid prescription pain relievers is a serious problem in their community, up from 33 percent two years ago. Opioids are now viewed as a serious problem more often than alcohol. Regarding heroin, 37 percent say it is a serious problem in their community, 25 percent regard it as moderately serious, and 33 percent say heroin is not a problem where they live.

Fifty-seven percent of Americans have experience dealing with substance misuse ranging from taking a painkiller that wasn’t prescribed to overdosing. Twenty-four percent say they have an addicted relative, close friend, or that they themselves are addicted to opioids. Forty percent are or know someone addicted to alcohol or another type of drug. Thirteen percent have lost a relative or close friend to opioids.

MOST AMERICANS SEE ADDICTION AS A MEDICAL PROBLEM, BUT FEW WANT TO ASSOCIATE WITH ADDICTS.

More than half of Americans consider opioid addiction to be a medical problem to be treated, and 4 in 10 think substance misuse is caused by a mental illness.

Most medical authorities define addiction as a disease. It is considered a chronic, relapsing brain disease by the National Institute of Health, the American Medical Association, and other medical organizations.6 

But while many Americans agree with these organizations, some view opioid addiction as a character issue rather than a physical or mental ailment. Forty-four percent say opioid addiction indicates a lack of willpower or discipline, and a third regard it as a character defect or the result of bad parenting. Those with experience with opioid addiction, either themselves or through a loved one, are more likely to say a substance use disorder is a medical problem to be treated than those without such experience (62 percent vs. 50 percent).

Although a majority of Americans view opioid addition as a medical issue, most would rather not closely associate with addicts. Most say they would be unwilling to work closely together with them on the job, live next door, or allow them to marry into their families.

Those who say addiction is a medical problem are more likely than those who say it is not to be willing to keep someone addicted to opioids as a friend (24 percent vs. 7 percent), spend an evening socializing (17 percent vs. 4 percent), live next door (13 percent vs. 4 percent), or work closely with them on the job (13 percent vs. 2 percent). They are no more likely to want them to marry into their family, however.

AMERICANS WANT A STRONGER LOCAL RESPONSE TO THE OPIOID EPIDEMIC.

Americans generally want their communities to do more to address the opioid crisis. Two-thirds say their community is not doing enough to make substance use programs more affordable and accessible, or to find ways to improve treatment for substance use.

Sixty-four percent of the public would like to see their community do more to crack down on drug dealers. 

While 55 percent say their community is not doing enough to crack down on drug users, 58 percent would like to see a lessening in the stigma of drug addiction and 59 percent think their community isn’t doing enough to educate the public and students about the issue. About half of Americans think their community needs to do more to educate prescribers about the risks of opioids.

Those who see addiction as a medical problem are especially likely to say their community is not doing enough to find ways to improve treatment compared with those who don’t (73 percent vs. 59 percent) or to reduce the stigma toward those with an opioid addiction (66 percent vs. 52 percent). Those familiar with opioid addiction themselves or through a loved one are more inclined than those without an experience with the condition to say their community needs to do better with treatment options (77 percent vs. 62 percent) and to crack down on drug dealers (74 percent vs. 60 percent).

OPIOID MESSAGING IS PREVALENT ON SOCIAL MEDIA.

Of the 74 percent of adults who use Facebook, 41 percent say they have seen messages about the opioid epidemic or death from overdoses. Fewer users of other social media platforms have seen messages about the problem of opioids.

Illicit opioid sales on the internet is a growing problem.7 But few report seeing offers to purchase opioids on social media platforms.

Forty percent approve of how President Donald Trump is handling the problem of opioid addiction in this country; 57 percent disapprove. Seventy percent of Republicans approve of the president’s handling of the issue, while just 40 percent of independents and 16 percent of Democrats say the same.8 

ABOUT THE STUDY

Survey Methodology

This survey was conducted by The Associated Press-NORC Center for Public Affairs Research, with funding from NORC at the University of Chicago. Data were collected using the AmeriSpeak Omnibus®, a monthly multi-client survey using NORC’s probability-based panel designed to be representative of the U.S. household population. The survey was part of a larger study that included questions about other topics not included in this report. During the initial recruitment phase of the panel, randomly selected U.S. households were sampled with a known, non-zero probability of selection from the NORC National Sample Frame and then contacted by U.S. mail, email, telephone, and field interviewers (face-to-face). The panel provides sample coverage of approximately 97 percent of the U.S. household population. Those excluded from the sample include people with P.O. Box only addresses, some addresses not listed in the USPS Delivery Sequence File, and some newly constructed dwellings.

Interviews for this survey were conducted between March 14 and 19, 2018, with adults age 18 and over representing the 50 states and the District of Columbia. Panel members were randomly drawn from AmeriSpeak. The survey was completed by 1,054 adults—939 via the web and 115 via telephone. Interviews were conducted in English. Telephone interviews were conducted by professional interviewers who were carefully trained on the specific survey for this study. The final stage completion rate is 23.9 percent, the weighted household panel response rate is 33.7 percent, and the weighted household panel retention rate is 88.1 percent, for a cumulative response rate of 7.1 percent. The overall margin of sampling error is +/- 4.1 percentage points at the 95 percent confidence level, including the design effect. The margin of sampling error may be higher for subgroups.

Once the sample has been selected and fielded, and all the study data have been collected and made final, a poststratification process is used to adjust for any survey nonresponse as well as any non-coverage or under- and oversampling resulting from the study specific sample design. Poststratification variables included age, gender, census division, race/ethnicity, and education. Weighting variables were obtained from the 2017 Current Population Survey. The weighted data, which reflect the U.S. population of adults age 18 and over, were used for all analyses.

All differences reported between subgroups of the U.S. population are at the 95 percent level of statistical significance, meaning that there is only a 5 percent (or lower) probability that the observed differences could be attributed to chance variation in sampling.

A comprehensive listing of the questions, complete with tabulations of top-level results for each question, is available on The AP-NORC Center website: http://www.apnorc.org. For more information, email info@apnorc.org.

Contributing Researchers

From NORC at the University of Chicago

Marjorie Connelly
Dan Malato
Jennifer Benz
David Rein
Sherry Emery
Michael Meit
Caitlin Oppenheimer
Trevor Tompson
Liz Kantor
Nada Ganesh

From The Associated Press

Emily Swanson

About The Associated Press-NORC Center for Public Affairs Research

The AP-NORC Center for Public Affairs Research taps into the power of social science research and the highest-quality journalism to bring key information to people across the nation and throughout the world.

The Associated Press (AP) is the world’s essential news organization, bringing fast, unbiased news to all media platforms and formats.

NORC at the University of Chicago is one of the oldest and most respected, independent research institutions in the world.

The two organizations have established The AP-NORC Center for Public Affairs Research to conduct, analyze, and distribute social science research in the public interest on newsworthy topics, and to use the power of journalism to tell the stories that research reveals.

The founding principles of The AP-NORC Center include a mandate to carefully preserve and protect the scientific integrity and objectivity of NORC and the journalistic independence of AP. All work conducted by the Center conforms to the highest levels of scientific integrity to prevent any real or perceived bias in the research. All of the work of the Center is subject to review by its advisory committee to help ensure it meets these standards. The Center will publicize the results of all studies and make all datasets and study documentation available to scholars and the public.

FOOTNOTES

1. Opioids are a class of drugs that produce effects similar to opium and include pain relievers available legally by prescription, such as OxyContin, Vicodin, and Percocet, as well as illegal drugs such as heroin. 

2. https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html 

3. https://www.washingtonpost.com/national/health-science/states-federal-money-for-opioid-crisis-a-small-step-forward/2018/03/25/41a284fa-3037-11e8-b6bd-0084a1666987_story.html?utm_term=.3077c6595ed4 

4. https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html 

5. https://www.cdc.gov/media/releases/2018/p0306-vs-opioids-overdoses.html 

6. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction 

7. https://www.nytimes.com/2018/01/24/us/politics/senate-investigation-china-mail-opioids.html 

8. http://www.apnorc.org/projects/Pages/Trade-and-Taxes-How-Americans-Feel-about-Recent-Economic-Policies-.aspx