Abstract
IMPORTANCE: Opioid overdoses in the US began to decline in 2024, concurrent with the transition to a new federal administration that will shape how the government prioritizes and responds to opioid overdose in coming years. Understanding US residents' current views on opioid overdose and addiction can inform future efforts to address these issues. OBJECTIVE: To examine how US adults view opioid overdose and people with opioid addiction in 2025, and how views vary by conservative, moderate, or liberal ideology. DESIGN, SETTING, AND PARTICIPANTS: This web-based survey of a national sample of adults who identified their race and ethnicity as non-Hispanic or Hispanic Black or non-Hispanic White was fielded April 7 to 28, 2025. MAIN OUTCOMES AND MEASURES: Respondents rated their perceptions of the seriousness of opioid overdose deaths in the US; the degree to which they viewed people who use opioids, their family members, pharmaceutical companies, governments (federal, state, and local), or nonprofits as responsible for reducing overdose deaths; and social distance attitudes (willingness to have a person with opioid addiction as a neighbor or marry into their family). RESULTS: Among the 1552 survey respondents (939 female [60.5%]; 523 aged 30-44 years [33.7%]; 756 non-Hispanic or Hispanic Black [48.7%]; 796 non-Hispanic White [51.3%]), 448 (28.9%) politically identified as conservatives, 615 (39.6%) as moderates, and 489 (31.5%) as liberals. Overall, 88.2% (95% CI, 86.0%-90.1%) of adults viewed opioid overdose deaths as serious, as did 83.4% (95% CI, 78.8%-87.1%) of conservatives, 88.7% (95% CI, 85.2%-91.5%) of moderates, and 93.4% (95% CI, 90.4%-95.6%) of liberals. Respondents viewed people who use opioids (81.0%; 95% CI, 78.4%-83.4%) and pharmaceutical companies (72.7%; 95% CI, 69.7%-75.4%) as most responsible for reducing overdose deaths. More liberals (83.4%; 95% CI, 78.6%-87.3%) identified pharmaceutical companies as responsible than people who use opioids (69.6%; 95% CI, 64.0%-74.3%). Regarding social distance, 38.3% (95% CI, 35.3%-41.5%) of respondents were unwilling to have a person with opioid addiction as a neighbor and 58.4% (95% CI, 38.5%-61.5%) were unwilling to have a person with opioid addiction marry into their family. Desire for social distance was greater among conservatives (neighbor: 52.0%; 95% CI, 46.5%-57.4%; marry: 71.0%; 95% CI, 65.9%-75.7%) vs moderates (neighbor: 34.0%; 95% CI, 29.2%-39.2%; marry: 54.4%; 95% CI, 49.2%-59.5%) or liberals (neighbor: 27.0%; 95% CI, 22.3%-32.4%; marry: 48.0%; 95% CI, 42.3%-53.7%). CONCLUSIONS AND RELEVANCE: In this 2025 survey study, US adults viewed opioid overdose as a serious problem. Different views on the degree to which individuals who use opioids, pharmaceutical companies, and governments are responsible for reducing overdose suggest that preferences for future actions to address overdose may vary among conservatives, moderates, and liberals.