Abstract
BACKGROUND: Negative public attitudes or stigma towards opioid use disorder (OUD) is associated with lower engagement in treatment for OUD. Studies examining correlates of opioid-related stigma are needed to better understand modifiable pathways to be targeted in stigma reduction interventions. PURPOSE: Grounded in the knowledge-attitude-behavior framework, this study examines an indirect pathway between medical mistrust and stigma towards individuals with a history of an OUD through opioid knowledge. Additionally, the study examines whether racial and sexual minority status moderates the relationship between opioid knowledge and opioid stigma. METHODS: The analytic sample included 6,310 participants who were recruited from the AmeriSpeak(®) panel and completed a survey on attitudes towards opioids and OUD between October 2021 and November 2021. RESULTS: Medical mistrust was negatively associated with opioid knowledge (B = -0.16, p < .001). In turn, opioid knowledge was negatively associated with opioid stigma (B = -0.18, p < .001). The association between opioid knowledge and opioid stigma was further moderated by both racial and sexual minority status. DISCUSSION: Findings offer insight into possible intervention and prevention programing. Opioid knowledge is modifiable and may be a mechanism for reducing stigma and improving attitudes towards people living with an OUD.