Stigma and personal contact predict support for harm reduction in Ireland

What is it about?

This mixed methods study examined how stigmatised attitudes towards people who use drugs (PWUD), beliefs about opioid use, and prior personal contact with PWUD relate to public support for two evidence-based interventions to reduce drug-related deaths in the Republic of Ireland and Northern Ireland: supervised injection sites and over-the-counter naloxone availability. Using quantitative scales measuring prejudice (including avoidance, condemnation and sympathy dimensions) and level of familiarity with PWUD, alongside qualitative analysis, the study found that prejudice can undermine support for both interventions even when people are broadly aware of the drug-related death crisis. Prior contact with PWUD was associated with greater support for harm reduction policies, consistent with the contact hypothesis. The research also found that believing PWUD deserve help rather than punishment was a key predictor of policy support.

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Why is it important?

The island of Ireland faces a serious and worsening opioid crisis, yet at the time of publication neither jurisdiction has yet implemented supervised injection facilities and naloxone access remains inconsistent. This study provides the first systematic mixed methods analysis of the psychological and social mechanisms by which public stigma creates a structural barrier to evidence-based policy implementation in an Irish context, and uniquely captures both jurisdictions across the island in the same study. The finding that sympathy-oriented campaigns and contact-based messaging could shift attitudes has direct implications for how harm reduction advocates, public health communicators and policymakers design strategies to build the public and political will needed to implement overdose prevention infrastructure. The research also identifies barriers specific to Northern Ireland, including paramilitary intimidation, that have no equivalent in the wider international literature on supervised injection facility implementation.

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