CHARRP Public Opinion Survey

We described public views toward harm reduction among Canadian adults and tested a social exposure model predicting support for these contentious services, drawing on theories in the morality policy, intergroup relations, addiction, and media communication literatures. A quota sample of 4645 adults (18+ years), randomly drawn from an online research panel and stratified to match age and sex distributions of adults within and across Canadian provinces, was recruited in June 2018. Participants completed survey items assessing support for harm reduction for people who use drugs (PWUD) and for seven harm reduction interventions. Additional items assessed exposure to media coverage on harm reduction, and scales assessing stigma toward PWUD (α = .72), personal familiarity with PWUD (α = .84), and disease model beliefs about addiction (α = 0.79). Most (64%) Canadians supported harm reduction (provincial estimates = 60% - 73%). Five of seven interventions received majority support, including: outreach (79%), naloxone (72%), drug checking (70%), needle distribution (60%) and supervised drug consumption (55%). Low-threshold opioid agonist treatment and safe inhalation interventions received less support (49% and 44%). Our social exposure model, adjusted for respondent sex, household income, political views, and education, exhibited good fit and accounted for 17% of variance in public support for harm reduction. Personal familiarity with PWUD and disease model beliefs about addiction were directly associated with support (βs = .07 and -0.10, respectively), and indirectly influenced public support via stigmatized attitudes toward PWUD (βs = 0.01 and -0.01, respectively). Strategies to increase support for harm reduction could problematize certain disease model beliefs (e.g., “There are only two possibilities for an alcoholic or drug addict – permanent abstinence or death”) and creating opportunities to reduce social distance between PWUD, the public, and policy makers.本研究阐述了加拿大成年公众对减害（Harm Reduction）的态度，并基于道德政策、群际关系、成瘾学及媒介传播领域的理论，构建并检验了预测公众对这类争议性服务支持意愿的社会接触模型。本研究于2018年6月招募了4645名成年参与者（年满18周岁），样本采用配额抽样方法，从在线研究面板中随机抽取，并按加拿大各省份及全国的成年人口年龄、性别分布进行分层校准。参与者完成了一系列调研题目，用以评估公众对吸毒人群（People Who Use Drugs, PWUD）的减害服务以及7类减害干预措施的支持意愿。另有调研题目用以评估参与者接触减害相关媒体报道的情况，同时采用多个量表测量其对吸毒人群的污名化态度（Cronbach’s α = 0.72）、对吸毒人群的个人熟悉程度（Cronbach’s α = 0.84），以及对成瘾问题的疾病模型认知（Cronbach’s α = 0.79）。多数（64%）加拿大人支持减害服务，各省的支持率估计值在60%至73%之间。7类干预措施中有5类获得了多数公众支持，具体包括：外展服务（79%）、纳洛酮（Naloxone）分发（72%）、毒品检测（Drug Checking）服务（70%）、针具分发（60%）以及药物监督消费（Supervised Drug Consumption）服务（55%）。低门槛阿片类激动剂治疗与安全吸入干预措施的支持率较低，分别为49%和44%。本研究构建的社会接触模型在控制参与者性别、家庭收入、政治倾向与受教育程度的影响后，拟合效果良好，能够解释公众对减害服务支持意愿中17%的变异量。对吸毒人群的个人熟悉程度与对成瘾问题的疾病模型认知，分别与减害服务支持意愿存在直接关联（标准化回归系数β分别为0.07与-0.10），并通过对吸毒人群的污名化态度对公众支持意愿产生间接影响（标准化回归系数β分别为0.01与-0.01）。提升公众对减害服务支持意愿的策略，可包括对部分疾病模型认知进行问题化解构（例如"There are only two possibilities for an alcoholic or drug addict – permanent abstinence or death"），并创造机会缩小吸毒人群、普通公众与政策制定者之间的社会距离。