Treatment and Non-Treatment Professionals in Texas: Race, Sex, Age, and Level of Education Influencing Attitudes About Addiction

• Author: Angela D. Broadus,Logan A. Yelderman,Shauna N. Richards
• DOI: 10.1177/0022042620971857
• Published date: 01 January 2021
• Date: 01 January 2021
• Subject Matter: Articles

https://doi.org/10.1177/0022042620971857

Journal of Drug Issues

2021, Vol. 51(1) 218 –235

© The Author(s) 2020

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DOI: 10.1177/0022042620971857

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Article

Treatment and Non-Treatment

Professionals in Texas: Race,

Sex, Age, and Level of Education

Influencing Attitudes About

Addiction

Shauna N. Richards1, Angela D. Broadus1,

and Logan A. Yelderman1

Abstract

Using a two-step process, attitudes about addiction among Texas professionals working

primarily with youth were examined. In Step 1, researchers examined attitudes about addiction

in Texas (n = 1,078), across professionals working with youth. In Step 2, researchers selected

a subset of treatment and non-treatment professionals (n = 522) and tested two hypotheses

related to differences in attitudes between the two professional groups. Two research questions

were also explored. Step 1 analyses revealed stronger endorsement of attitudes related to

the psychological and sociological models, and that demographic variables were modest but

significant predictors of attitudes about addiction. Step 2 analyses revealed that professional

status and demographic variables were significant predictors of attitudes about addiction.

Findings have implications for treatment seeking, treatment and non-treatment professional

behavior toward adolescents with substance use issues, and the need for continuing education

to reduce stigma.

Keywords

attitudes, addiction, treatment professional, non-treatment professional

Individuals may become physiologically and psychologically addicted to psychoactive sub-

stances such as marijuana, stimulants, alcohol, or opioids, or to behaviors such as gambling or

eating (American Psychiatric Association, 2013; Lang & Rosenberg, 2017). Public response

toward these individuals, and even toward those in recovery from addiction, has generally been

negative and has included stigma and discrimination (Ahern et al., 2007; Mundon et al., 2015;

Schomerus et al., 2010). An analysis of stigma trends in the 1996 and 2006 General Social

Surveys suggested an increase in stigma toward individuals with alcohol addiction (Pescosolido

et al., 2010). In addition, individuals with alcoholism and substance addiction are among the

1Prairie View A&M University, TX, USA

Corresponding Author:

Shauna N. Richards, Prairie View A&M University, 575 Anne Preston Street, MS 2600, Prairie View, TX 77446-0519,

USA.

Email: srichards3@student.pvamu.edu

971857JODXXX10.1177/0022042620971857Journal of Drug IssuesRichards et al.

research-article2020

Richards et al. 219

most stigmatized individuals with disorders, and there is general un-willingness to affiliate with

them (Crisp et al., 2000; Lang & Rosenberg, 2017; Yang et al., 2017).

Some treatment professionals exhibit negative attitudes toward those with substance use

addiction (“Poll Looks at American Attitudes Toward Recovery,” 2008; Rao et al., 2009; van

Boekel et al., 2013). Rao et al. (2009) noted that health professionals in their study expressed

more stigmatizing attitudes toward individuals with active substance use disorders than toward

those who were recovering. Similarly, in a meta-analysis of health professionals’ attitudes toward

patients with substance use disorders, van Boekel et al. (2013) noted that health professionals’

attitudes toward those with substance use disorders were generally negative, related to blaming,

and that in at least two cases, these attitudes were associated with less optimal care.

Although general research about public attitudes and treatment professionals’ attitudes toward

those with addiction is available, research examining attitudes about addiction among specific

non-treatment professionals within the criminal justice system is limited. In addition, research

comparing attitudes between treatment and non-treatment professionals is limited. Such research

is important because in professional settings, attitudes toward those with addictions have impli-

cations for initial contact and subsequent treatment decisions. Especially as it relates to youth, the

attitudes of contacting professionals can help to determine the future landscape of youth with

substance use disorders or those arrested for driving while under the influence, sale/manufactur-

ing of substances, or possession of substances (Texas Department of Public Safety, 2020). Such

attitudes also have implications for treatment seeking behavior, treatment efficacy, and treatment

compliance (van Boekel et al., 2013).

Using two steps, this research project explored attitudes about addiction among professionals

in Texas who work primarily with youth. This research then makes a contribution to the literature

on attitudes about addiction as it compares attitudes about addiction held by treatment and non-

treatment professionals. This is an especially novel contribution because the non-treatment pro-

fessionals in the sample are employed within the state’s criminal justice system, a novel

comparison group. Furthermore, the study examines the relationship between treatment and non-

treatment professionals’ attitudes and other variables such as sex, level of education, age, and

race. Finally, implications for treatment professionals and non-treatment professionals, as well as

for individuals receiving treatment, are discussed.

Models of Addiction

Mosher & Akins (2007) and Schaler (2000) created frameworks for perspectives about addiction.

Mosher & Akins (2007) categorized beliefs about addiction into a set of models (psychological,

disease/genetic, sociological, and nature) while Schaler (2000) described a moral model. Each of

these models describe etiology for addictive behaviors and beliefs regarding the likelihood for

successful treatment. The psychological model proposes that addiction stems from maladaptive

coping mechanisms for life’s challenges. Individuals endorsing this model perceive addiction as

associated with anxiety, low self-esteem, lack of resilience, and problems with emotional regula-

tion. The psychological model also proposes that treatment is more effective than punishment

and recovery is possible if the underlying issues are resolved. Endorsement of this model pro-

motes compassion toward those with addiction.

The disease/genetic model uses a biological perspective and describes substance use disorders

as a “chronic, relapsing, brain disease,” with heritability risks and a neurobiological etiology

(Leshner, 1997; McLellan, 2002; Mosher & Akins, 2007; Volkow et al., 2016). Individuals who

endorse this model perceive addiction as similar to chronic diseases such as hypertension or dia-

betes where the symptoms can be managed but with no “cure.” This model considers addiction

to be a “relapsing” brain disease because psychoactive substances change the brain at a cellular

level, with relapse as a common occurrence on the road to recovery. Researchers hoped that an