Public perceptions of opioid misuse recovery and related resources in a nationally representative sample of United States adults

Aims: To understand how the US public defines recovery from opioid misuse and the recovery-related resources it views as most helpful, and to compare differences by opioid misuse history and demographic characteristics. Design: Observational study of data from the nationally representative AmeriSpeak((R)) Panel survey administered in October/November 2021. Setting: United States. Participants: 6515 adults (>= 18years). Measurements: Respondents ranked 10 definitions of recovery (religious in nature; spiritual in nature; physical/mental in nature; contributing to society; enhanced quality of life; seeking professional help; having a sense of purpose; moderate/controlled substance use; no drug use; abstaining from all substance use) and 9 resources that might contribute to recovery (primary care physician; intensive inpatient program; residential rehabilitation program; self-help group; therapist/psychologist/social worker; prescribed medication; talking to family/friends; spiritual/natural healer; faith-based organization). We explored differences in rankings by opioid misuse history (personal vs. family/friend vs. no history) and demographic characteristics (race, sex, age) using multivariable ordinal logistic regression. Findings: Seeking professional help was the most endorsed recovery definition overall [mean (M)=6.97, standard error (SE)=0.03]. Those with personal opioid misuse history ranked enhanced quality of life (B=0.16, P=0.049) and having a sense of purpose (B=0.16, P=0.029) significantly higher, and ranked abstaining from substance use (B=-0.20, P=0.009) significantly lower as recovery definitions than those without a history of opioid misuse. Compared with White respondents, Black (B=0.60, P<0.001) and Hispanic (B=0.55, P<0.001) respondents defined recovery as more religious in nature. Residential rehabilitation program was identified as the most helpful resource for recovery (M=7.16, SE=0.02), while prescribed medication received a relatively low ranking overall (M=4.05, SE=0.03). Those with family/friend opioid misuse history ranked prescribed medication as less helpful than others (B=-0.14, P=0.003). Conclusions: The general US public's views around recovery from opioid misuse appear to focus on abstinence and formal treatment receipt, while people with a history of opioid misuse place less emphasis on abstinence and greater emphasis on other aspects of well-being.