Cross sectional examination of public perceptions around substance misuse using state behavioral risk factor surveillance system data

BACKGROUND: This study aimed to explore public sympathy toward individuals with substance misuse, including relationships between that phenomenon and demographic, socioeconomic, and health factors in a single U.S. state. METHODS: Weighted summary statistics and logistic regression analyses were conducted using data from the 2021 Utah Behavioral Risk Factor Surveillance System. The outcome measure was derived from a unique question which asked about sympathy toward those misusing substances, which may reflect behaviors indicative of or preceding substance use disorder (SUD). Other measures included standard demographics; education; religious affiliation; veteran status; LGBTQ+ status; history of cigarette, alcohol, and marijuana use; and health status. RESULTS: Older age, Hispanic race/ethnicity, affiliation with several Christian religions, residence in rural counties, and lack of health insurance were negatively related to sympathy toward individuals misusing substances. Those with past-month marijuana use, higher education, and current poor mental health were significantly more likely than their counterparts to express this sympathy. CONCLUSIONS: This state-level measure of sympathy toward those misusing substances allowed for detection of both previously known and potentially newly identified predictors of sympathy around substance misuse and, potentially, disorders. Efforts should be made to measure SUD sympathy or stigma in nationally-representative datasets. The knowledge derived from such data could be used to increase SUD sympathy and reduce SUD stigma. In addition, further research in this area should focus on education level and religion.