Dangerous Attitudes:Stigma, Discrimination &

Injecting Drug UseCo –authors:

Annie MaddenLaura Liebelt Jude Byrne

Overview

• Overview of National Anti-Discrimination Campaign

• Overview of market research AIVL commissioned as the first stage of a National Anti-Discrimination Campaign:– Why we commissioned the market research– Market research methodology– Main themes from the market research– Recommendations from the market research

AIVL National Anti-Discrimination Project

• National Anti-Discrimination Project:– Market Research Phase– Stigma & Discrimination Literature & Research

Analysis Report – Campaign Development & Evaluation– Campaign National Roll Out– Online Reporting System– National Healthcare Student Training Module

Market Research:Objectives• Better understanding of community perceptions

of people who inject drugs (PWIDs);• Exploring existing stereotypes;• Understanding why the stigma/prejudice exists;• Exploring how community might respond to

messages aimed at addressing misconceptions and prejudices.

Market Research:Methods• November 2009 – February 2010

• 1st Stage - Stakeholder Engagement – Defining the Issues:– Delegates attending AIVL’s 2009 AGM & National Meeting

• 2nd Stage - Focus Groups – Sydney & Adelaide– Medical & health professionals

– General public

Sample of the group profiles with the general public and medical professionals focus groups

Group Target group Demographic Attitudinal criteria Location

1

General Public

Parents of 15-28 year oldsParents must be aware that their children use recreational drugs

and relatively comfortable with thisSydney

2Regular / occasional drug users

(non –injectors) age 18-24Use illicit drugs one or more times a month (non- injecting)

Sydney

3 18-30 year olds

Respond positively to attitudinal statements that indicate that enjoy

use of alcohol and / or illicit drugs themselves

Adelaide

4 Over 30 years of ageAdelaide

5 Medical Professionals N/A Inclusion of GPs, pharmacists, nurses in emergency units Sydney

Market Research:General Public• All felt there was a clear line of what was not

acceptable in drug taking: – Social occasions were acceptable, using drugs alone were not, seen as

undesirable when it became an ‘addiction’ (notions of ‘addiction’ based heavily on stereotypes)

• Attitudes Towards People Who Inject Drugs: – Very negative;– Saw as people where drugs are their only priority in life; – Would not associate with PWIDs;– Scared of PWIDs – unpredictable and volatile– Fear of contagion – particularly risk of HIV and Hep C - needle stick– But then admitted that didn’t knowingly know anyone who injects or

has injected drugs – entirely reliant on stereotypes

Market Research:General Public

Attitudes Towards People Who Inject Drugs cont...– No empathy as line had been crossed and users

aware of consequences– All respondent were aware of the labelling and

stereotyping and felt no discomfort about it. – In fact they thought it was important to ensure drug

users were discriminated against, so they did not spread the behaviour

• Stigma Exists for a Reason – good for drug users, good for community as a whole as it acts to prevent people taking up the behaviour!!!

Market Research:Medical Professionals

• Attitudes towards PWIDs varied with the experience of medical professionals : – The more experienced were more likely to be understanding about the

difficulties that people who inject drugs may face in certain situations than the less experienced medical professionals in the group discussion

– The experienced medical professionals in the group discussion had generally chosen to work in areas where they came into contact with PWIDs

• Still expressed many views and opinions similar to general public, especially in regard to physical and social stereotypes.

Market Research:Medical Professionals

Mains causes of stigma and discrimination among medical professionals includes:

• care of PWIDs tends to be considered relatively time consuming, especially in time poor places such as emergency rooms at hospitals and pharmacies;

• lack of knowledge and experience with PWIDs throughout education - medical professionals tend to begin their working life with the same perceptions of PWIDs as the general community, but have the additional responsibility for having to treat them medically;

Market Research:Medical Professionals

• perceived negative impact on other patients and the image of surgery or pharmacy, which ultimately impacts on the business; and

• the apparent inconsistency between the harm inflicted by PWIDs on themselves and the goal of medical professionals in providing for health, resulting in medical professionals questioning the reason that the person who inject drugs may be seeking their assistance.

• The assumptions is that people are drug seeking – perpetuates negative stereotypes.

Market Research: Recommendations• Too difficult to change all community attitudes:

– Directly challenging strong beliefs against PWIDs likely to be ineffectual;

– Concepts that evoke sympathy for PWIDs for no apparent reason or tended towards a strategy of ‘normalising’ injecting resulted in angry reactions among some of the general public.

• Will have to work with current perceptions and prejudices: the fact that these may not be true or accurate does not matter.

• ‘Humanising‘ those that are trying to overcome an addiction: one possible answer...

• Jody has been an injecting drug user for a number of years. She’s doing all she can to kick her addiction and is now on a methadone program.

• Prejudice against drug users from everyday people makes fighting the addiction harder

• Give those fighting their addiction your support

WHO IS THE INJECTING DRUG USER?

• Sadly Jim is homeless because of some mental health issues• And David, who runs his own business is an injecting drug user

Leave your prejudices at the door …

DavidBusiness man

RuthMother

JimHomeless

SueTeacher

GaryBuilder

Market Research – Communication Issues

Market Research: Recommendations• Some of the positive and negative responses to this

concept were:• “Can be anyone, not just homeless people and

prostitutes.”• “It’s very important that people separate the action of

injecting from the image of a junky on the street.”• “Can make drugs normalized”• “It says that even if you inject drugs you can still be

successful. Do we really want people to think like that?”

WHICH IS THE MOST DANGEROUS

• Alcohol causes more social issues, more domestic violence, and costs the community more than injecting drug users

BRUSHING IT UNDER THE CARPET DOESN’TMEAN IT DOESN’T EXIST

‘AT HOME’‘AT NEEDLE EXCHANGE’

THESE PEOPLE SHARE SOMETHING IN COMMON

They all inject drugs …

YOU WOULDN’T DISCRIMINATE AMONGST THESE PEOPLE

• So why discriminate against these

Woman HIV Positive Mental Health PhysicalDisability

Gay Black

Injecting Drug User Injecting Drug User Injecting Drug User

Market Research - Recommendations• Key difficulty - strong perception that the stigma is perceived

to exist for a reason. • Current social and legal environment - many feel that stigma

and discrimination toward people who inject drugs is an important means of containing the practice and should exist.

• Younger respondents tended to respond more positively towards the concepts overall than older respondents.

• Women (of all ages) were more likely to have some empathy towards people in difficult circumstances.

• Communications aimed at younger people and women may be successful.

Further Information

• Market Research report available at:www.aivl.org.au

(in ‘What’s New;)

• Contact:LauraL@aivl.org.auJudeB@aivl.org.au

Video Break the habit.flv

“Think an ad blaming McDonalds for a man’s death is a little extreme? Check out this

Australian spot, which likens a mother feeding her child a hamburger to injecting him with

heroin. It ends with the question, "You wouldn't inject your children with junk. So why are you

feeding it to them?" Perhaps because addictive, dangerous drugs aren't the exact same thing as

unhealthy food?” Eater National