# Opioid Use Disorder Pharmaceutical Treatments: Investigating a Model and Measure of Intervention Stigma toward Medication (OPTIMISM)

> **NIH NIH R15** · UNIVERSITY OF MISSOURI-ST. LOUIS · 2024 · $421,499

## Abstract

Project Summary/Abstract
Medication for Opioid Use Disorder (MOUD) is an effective but underused treatment for Opioid Use Disorder
(OUD), reducing drug use and mortality at rates far superior to any other treatment modality. Current approved
medications include methadone (a full opioid agonist), buprenorphine (a partial agonist), and naltrexone (an
opioid antagonist). Despite its efficacy, MOUD remains heavily stigmatized by decision makers, healthcare
personnel, and members of the general public (i.e., three stigma actor groups), with potential for differential
endorsement and experience of stigma based on lived experience of OUD and racial identity. Existing qualitative
research suggests this form of Intervention Stigma, manifesting both as negative attitudes (e.g., “it’s replacing
one addiction for another,” “it’s not ‘real recovery,’”) as well as actions (e.g., prohibitions on MOUD in residential
environments, poor reimbursement in medical settings) are driven by beliefs regarding the following domains: 1)
MOUD’s differing pharmacological properties (opioid agonists, partial agonists, and antagonists), 2) prioritization
of psychosocial interventions over medication, 3) regulatory and administrative burdens, 4) the value of
experiential knowledge and professional anecdote over scientific research or client experience, and 5) suspicion
of profit motives associated with MOUD. Evidence also suggests there is a sixth domain, risk of MOUD diversion
(selling and sharing medications), influencing Intervention Stigma. Though qualitative work helps illuminate the
sub-constructs of Intervention Stigma, there remains no comprehensive model or quantitative measure of
Intervention Stigma for use in academic or clinical settings which captures the nuance of stigmatizing attitudes
and actions across stigma actor groups, subpopulations, domains, routes of administration (injection vs. oral),
and the three medication types. The proposed study aims to develop a dimensional model of Intervention
Stigma by leveraging strong, statewide and national collaborations to engage with subject matter experts
through the validated delphi and cognitive interviewing techniques to test and refine domains of interest and
specific items. Following the establishment of the comprehensive model, the research team will develop and
test an Intervention Stigma measure tailored for the three target actor groups and apply modern,
multidimensional psychometric approaches to identify response patterns, scale structures, and establish
construct and convergent validity evidence for each actor group version, using both online and in-person formats
with large sample populations across diverse settings. Critically, the research team will consist of undergraduate
and graduate student scholars and will build strong substance use focused research and training
infrastructure within the Department of Psychological Sciences at the University of Missouri, St. Louis. The
long-term goal of this projec...

## Key facts

- **NIH application ID:** 10974580
- **Project number:** 1R15DA059765-01A1
- **Recipient organization:** UNIVERSITY OF MISSOURI-ST. LOUIS
- **Principal Investigator:** Rachel Winograd
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $421,499
- **Award type:** 1
- **Project period:** 2024-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10974580

## Citation

> US National Institutes of Health, RePORTER application 10974580, Opioid Use Disorder Pharmaceutical Treatments: Investigating a Model and Measure of Intervention Stigma toward Medication (OPTIMISM) (1R15DA059765-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10974580. Licensed CC0.

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