BISMARCK, N.D. – Gov. Doug Burgum and First Lady Kathryn Burgum today shared the results from the North Dakota Addressing Addiction survey at Recovery Reinvented.

Dr. Valerie Earnshaw, the study’s principal investigator, presented the results to an in-person crowd of about 600 people, with over 1,000 also viewing the event online. North Dakota’s Recovery Reinvented Initiative in the Office of the Governor, the University of Delaware, and the Addiction Policy Forum conducted a statewide survey to better understand the prevalence of substance use disorder (SUD) stigma in North Dakota.

The study found that stigma across the state has improved over the last three years, with 74% of North Dakota residents reporting that addiction is a health condition. Data collected from a previous 2018 survey on attitudes and beliefs around addiction among North Dakota residents showed that 63% of respondents agreed that addiction is a disease and needs to be treated as a health condition.

"To truly move the needle with ending stigma, we need to be able to make data-driven decisions," First Lady Burgum said. "The results from the North Dakota Addressing Addiction survey will help us share knowledge to communities on addiction, promote evidence-based interventions and identify partnership opportunities with communities and stakeholders.”

“The fact that three out of four of the respondents to the 2021 survey understood that addiction is a health condition is great news,” said Earnshaw, associate professor and faculty scholar in the Department of Human Development and Family Sciences at the University of Delaware. “It suggests that efforts aimed at increasing knowledge and reducing stigma in North Dakota may be paying off.”

Public health responses to addiction are preferred over criminal justice penalties

Nearly half of respondents (46%) support laws that protect people with addiction from criminal charges for drug crimes if they seek medical help, while 22% indicated that all people who use drugs illegally should be arrested and prosecuted. Three out of four (74%) support making Naloxone (lifesaving opioid reversal medication) available to friends and family members of people with opioid use disorder, and 69% of respondents support increasing government spending on addiction treatment.

Stereotypes and discrimination are low throughout the state

Stereotypes, or the inaccurate beliefs about people in recovery as a group, were relatively low among all survey respondents. Only 4% of respondents agreed that people in recovery are dangerous, 8% indicated they cannot be trusted, 9% indicated they do not make good decisions, and 19% selected individuals in recovery are to blame for their own problems.

Low levels of discrimination were found in social contact categories. The majority of respondents expressed willingness to work with someone in recovery (88%), to have someone in recovery as a neighbor (87%) and to introduce someone in recovery to their friends (87%). However, less than half of the respondents felt comfortable having someone in recovery as a caretaker of their children (31%), renting a room in their home (34%) or marrying into their immediate family (46%).

Higher levels of prejudice toward individuals with substance use disorders remain in the state

Prejudice, or the emotions experienced in response to interacting with someone in recovery, were relatively split statewide. Over half of the participants felt comfortable (53%) and supportive (53%) interacting with someone in recovery. However, nearly half of the participants expressed that they would feel anxious (49%) or nervous (48%) interacting with an individual in recovery. 

Lived experience and professional expertise are key factors in lower levels of stigma

Participants who have a loved one impacted by addiction, are in recovery themselves, or are professionals in the addiction field show significantly lower rates of stigmatizing feelings, thoughts and behaviors. Overall, impacted respondents endorsed 36% of stereotypes, 47% of prejudice and 32% of discrimination items. In comparison, non-impacted respondents endorsed 46% of stereotypes, 57% of prejudice and 45% of discrimination survey items.

“Stigma prevents people from asking for help and accessing evidence-based treatment when they need to, which ultimately hurts patients and families,” said Jessica Hulsey, executive director of Addiction Policy Forum. “North Dakota is using science to tackle the stigma around addiction, and it’s working. We hope that this groundbreaking research can be carried out in other cities and states across America.”

Research has found that individuals who experience stigma due to an SUD are more likely to continue engaging in substance use, and manifest greater delayed treatment access and higher rates of dropout. The three major domains of stigma include 1) stereotypes, the inaccurate beliefs or thoughts about a particular group of people; 2) prejudice, negative feelings or emotions towards a particular group; and 3) discrimination intent that includes negative or unjust treatment of a particular group.

The full survey report, “2021 North Dakota Stigma Survey: Findings on Attitudes, Levels of Stigma and Support of Key Policies to Address Addiction,” is available on the Recovery Reinvented website: www.recoveryreinvented.com/survey.