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Research suggests crisis communication needed to curb opioid epidemic starts with empathy

Opioid use disorder (OUD) is a life-threatening, public health crisis that affects millions of Americans. The way we talk about OUD, according to recent research by Auburn University School of Communication & Journalism faculty, could significantly affect the policies designed to address it.

Assistant Professor of Communication Victoria Ledford has studied stigma for more than 10 years. Her work on OUD stigma began in the heart of Appalachia, where deadly overdoses occur more often than anywhere else in the country.

While studying stigma in graduate school, Ledford overheard a conversation between two people about Narcan, the overdose response drug. One individual argued that an individual only has a right to Narcan once – after that, they said, help should be withheld.

“I was so horrified by that statement that I said, ‘We have got to figure out how to stop this conversation,’ because the conversation is clearly affecting policy,” Ledford said. “That led to a series of studies trying to figure out how the communication we use to talk about people can actually affect what policies people vote for.”

Ledford’s latest research, titled “The peril of opioid stigma peril: Experimental evidence for removing danger-based health appeals,” studies how messages about OUD affect support for different policies.

“Stigma peril” refers to communication about people with OUD harming others or society. While this may be part of a person’s story, Ledford said it feeds a vicious cycle.

When stigma peril is shared, support for rehabilitative policy decreases, people with OUD lack the resources needed to recover and continue to suffer from OUD, which is then turned into a stigma peril story and starts the cycle anew.

“We read a stigmatizing message about a person with an opioid use disorder, and we draw the conclusion that people with opioid use disorder are harmful or irresponsible,” Ledford said. “We spread these messages and then those messages impact how people make decisions. Our communication matters and we can either use it for good, or we can use it for stigma.”

The challenge for health scholars is distinguishing between risk messages and stigma peril. Risk messages focus on how a health behavior or outcome is harmful, which is a proven strategy to reduce negative health behaviors.

Ledford said humanizing an OUD story but focusing on harm done to others may inspire fear toward people instead of the opioids themselves.

“Peril is not too far from risk messages because peril is the message that people who do that health behavior are harmful,” Ledford said. “My concern as a health scholar and working on grants to improve public health outcomes is we don’t want to promote health messaging that has unintended negative consequences.”

Ledford’s study found that people exposed to stigma peril messaging expressed more anger, frustration and disgust, and less support for people with OUDs.

One promising avenue for positive change that Ledford now works to explore is the positive effect of highlighting people in OUD recovery. By reframing opioid-related messages to focus on how supportive policy saved lives, from the people who experienced it firsthand, Ledford hopes to link communicating with empathy, reducing stigma and curbing the opioid crisis.

“First-person stories from the perspective of people with opioid use disorder that chart a more nuanced, humanizing path to recovery are working,” Ledford said. “Those stories introduce us to a real person who’s a human beyond their opioid use disorder. Humanity would be a better place if we saw people as people and not just their stigma.”

Read Ledford’s research in full in “Stigma and Health” from the American Psychological Association.

Tags: Communication and Journalism Research Faculty