(WITHDRAWN) Comparing Attitudes Toward Stigmatized Deaths: Suicide & Opioid Overdose Deaths

Background/Purpose Not only have suicide rates in the U.S. steadily increased over the past two decades, but there has also been a dramatic spike in drug overdose deaths – most involving synthetic opioids – in recent years. Given the strong association between suicide and substance use, as well as the harmful consequences of stigma, it is important to investigate whether these two types of deaths share similar stigmatized perceptions and ambivalence towards intervention that would impede prevention and treatment efforts for both of these public health issues. Hence, this study is the first to conduct a comparative analysis of attitudes toward suicide and unintentional opioid overdose deaths.

Methods Respondents were recruited for an online survey through convenience sampling. Respondents were randomly assigned to one of two groups: (1) those that responded to questions related to suicide and (2) those that responded questions about opioid overdose death. Respondents’ attitudes toward suicide were measured using the 16-item short form Stigma of Suicide Scale (SOSS-SF) and the Willingness to Intervene Against Suicide – Intention subscale (WIS-I). In order to make a direct comparison between the two types of deaths, both measures were adapted to measure attitudes toward opioid overdose deaths by changing the language to focus on individuals who die by opioid overdose.

Results The sample consisted of 503 respondents. Respondent age ranged from 18-77 years of age, (M=38.5, SD=12.45) and slight majority were female (N=258, 51.3%). Over half of the sample had known someone who had died by suicide (N=266, 52.9%) and 35.2% (N=177) had exposure to someone who had died by unintentional drug overdose.

Findings showed that participants in this study endorsed more negative language and less glorified views of opioid overdose decedents, had lower attribution of isolation to overdose deaths, and were less willing to intervene against overdose. Based on individual item analysis, results showed that respondents who were asked about an overdose decedent had significantly greater endorsement of the following items as compared to those who were asked about a suicide decedent: Pathetic, An Embarrassment, Irresponsible, and Stupid.

Furthermore, respondents were significantly more willing to intervene in a hypothetical case of a person at-risk for suicide than those who were asked about a person at-risk for opioid overdose. For example, as compared to those asked about a person at-risk for overdose, respondents in the suicide condition showed significantly greater willingness to (1) share their concern with a friend about the person at-risk, (2) contact that person’s family to express concern, (3) express concern directly to the person at-risk, and (4) to intervene in “some way.”

Conclusions and Implications Taken together, these findings could be interpreted as more severe stigmatization of substance-dependent individuals who die by opioid overdose for the present sample. Additional studies are needed to further explore the multidimensional nature of these attitudes. Considering that there is still so little known about the complexities of stigma towards suicide and opioid overdose, future research can also help us better understand how to change attitudes and improve prevention efforts.