1. MSc in Addiction Studies Exploring our attitudes toward addiction Anna Williams and John Witton

2. Outline Questionnaire Presentation with interruptions – Discussion in small groups – Discussion in the larger group Conclusion Continuation… – Reading – Group result – Follow-up

3. Think to yourself Why is it important to understand our/others’ attitudes towards Addiction?

4. Attitudes “Attitudes are reinforced by beliefs and often attract strong feelings which may lead to a particular behaviour intents.” Oppenheim (1999), page 175

5. Clinicians' expectations influence placebo analgesia Gracely et al. (1985) Lancet

6. Attitudes towards Drug Use 1.Valued physical goods 2.Behaviour/Social Behaviour 3.Intimate Behaviour (into the body) 4.Affects thinking, feeling and behaviour (psychoactive aspect) Robin Room (2005) D&A Review

7. Prized/Feared

8. THE BIG ISSUE CrimeIllnessMoral

9. Social Disapproval

10. Public Attitudes A Review by Schomerus et al (2010) Compared to other mental health disorders, Alcohol Dependents are: – Less ‘mentally ill’ – Responsible for their condition – As dangerous as those suffering from schizophrenia Experimental study by Graves et al (2005): students presented greater physiological arousal (i.e. increased heart rate) when they imagined meeting a person with a diagnostic of schizophrenia ….

11. Public Attitudes Preferences of the public regarding cutbacks in expenditure for patient care (Schomerus et al., 2006): psychiatric over medical alcoholism had least public support (personal responsibility). Dependents on drugs, alcohol, tabacco should receive less priority in health care (Olsen et al. 2003) Behaviour contribute to their own illness

12. Influenced by… Policy – ‘War on drugs’, ‘thought on drugs’, ‘just say no’ Representations of Drug Use and Drug Users in the British Press, 2010: – Professionals and celebrities linked to cocaine use – Young people cannabis and ecstasy users – Offenders and parents- heroin users

13. Small Groups What other factors influence our/others’ attitudes towards Addiction? What are the consequences of stigmatization to the patient?

14. On Stigma Thornicroft et al. 2007 Knowledge (ignorance)Attitudes (prejudice)Behaviour (discrimination) “The rejecting behaviour of others may bring greater disadvantage than the primary condition itself.”

15. Self-stigma Internalisation of negative public perception Self-stigma associated with: – ↓ self-efficacy (self-fulfilling prophecy) – ↓ Low self-esteem – ↑Depressive symptoms – ↑ Need of treatment – ↓ Seek help/treatment/use of health services

16. Current treatment system may stigmatise people in recovery The Effect of Stigma on Treatment (Luoma et al., 2007) – ↑ treatment episodes ↑ the stigma – IV users ↑ stigmatised Room 1980: ‘process of entering treatment is to some extent a process of extrusion from the general population, that many clients come to treatment after having exhausted their moral credit with employers and families’

17. Current treatment system may stigmatise people in recovery ‘Master status’ Multiple stigma Charlie Lloyd, 2010

18. Historically routed and difficult to Change

19. Is stigma all that bad?

20. Larger Group Discussion Can prevention happen without stigmatization? How can negative attitudes towards addiction be change?

21. Public Opinion Professionals Families and Friends User Evidence Conclusion

22. Reflect on your own attitudes towards addiction READING: