title: Public opinion of drug treatment policy: exploring the public's attitudes, knowledge, experience and willingness to pay for drug treatment strategies.
abstract: BACKGROUND
  Research evidence is strong for opiate replacement treatment (ORT). However, public opinion (attitudes) can be at odds with evidence. This study explored the relationships between, attitudes, knowledge of drugs and a range of socio-demographic variables that potentially influence attitude. This is relevant in the current policy arena in which a major shift from harm reduction to, rehabilitation is underway.
  
  
  METHODS
  A cross sectional postal questionnaire survey in Scotland was conducted where the drug, treatment strategy has changed from harm-reduction to recovery-based. A random sample (N=3000), of the general public, >18 years, and on the electoral register was used. The questionnaire was largely structured with tick box format but included two open questions for qualitative responses. Valuation was measured using the economic willingness-to-pay (WTP) method.
  
  
  RESULTS
  The response rate was 38.1% (1067/2803). Less than 10% had personal experience of drug, misuse but 16.7% had experience of drug misuse via a friend/acquaintance. Regression modelling revealed more positive attitudes towards drug users in those with personal experience of drug misuse, (p<0.001), better knowledge of drugs (p=0.001) and higher income (those earning >£50,000 per, annum compared to <£15K; p=0.01). Over half of respondents were not willing to pay anything for drug treatment indicating they did not value these treatments at all. Respondents were willing-to-pay most for community rehabilitation and least for methadone maintenance treatment. Qualitative analysis of open responses indicated many strong negative attitudes, doubts over the efficacy of methadone and consideration of addiction as self-inflicted. There was ambivalence with respondents weighing up negative feelings towards treatment against societal benefit.
  
  
  CONCLUSIONS
  There is a gap between public attitudes and evidence regarding drug treatment. Findings suggest a way forward might be to develop and evaluate treatment that integrates ORT with a community rehabilitative approach. Evaluation of public engagement/education to improve knowledge of drug treatment effectiveness is recommended.
authors: Centre of Academic Primary Care, University of Aberdeen, United Kingdom. Electronic address: c.i.math@abdn.ac.uk.
authors: C
authors: C
authors: Matheson
authors: Division of Applied Medicine (Psychiatry), University of Aberdeen, United Kingdom.
authors: M
authors: M
authors: Jaffray
authors: Health Economic Research Unit, University of Aberdeen, United Kingdom.
authors: M
authors: M
authors: Ryan
authors: Primary Care Section Lead, University of Aberdeen, United Kingdom.
authors: C M
authors: CM
authors: Bond
authors: Applied Health Sciences, University of Aberdeen, United Kingdom.
authors: K
authors: K
authors: Fraser
authors: Applied Health Sciences, University of Aberdeen, United Kingdom.
authors: M
authors: M
authors: Kirk
authors: Scottish Drugs Forum, United Kingdom.
authors: D
authors: D
authors: Liddell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000191:economics; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000191:economics / Q000379:methods*; D009293:Opioid-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D010865:Pilot Projects; D011639:Public Opinion; D012044:Regression Analysis; D012606:Scotland; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Attitudes; Drug treatment approaches; Public opinion; Treatment policy