How Opioid Treatment Centers Can Overcome NIMBYism

Some Fairmount residents are upset that a nearby homeless shelter is being turned into a triage center for addiction without the involvement of the surrounding community. The news about the shelter’s expansion came just a week before deafening closing of the camp people experiencing homelessness and addiction in Kensington, which has long been at the center of the regional opioid crisis.

The neighbors quickly started a petition to stop the triage center projectand they collected over 1,100 signatures. At a controversial community meeting, they expressed fears that their neighborhood would become “Kensington 2.0

How professors of political science AND Public policywe surveyed public opinion on opioid treatment policies in the US Our research shows that while Americans recognize the general need for opioid addiction treatment centers, they do not like these services being located close to where they live. It’s “not in my backyard” – or NIMBY – there is opposition it affects people across the ideological spectrum.

We also found that whether people support increased spending on opioid treatments or not depends on whether they share a racial identity with people they see can benefit from this policy.

We conducted a series of experiments and collected survey data from respondents in cities and villages across the country to understand how both of these dynamics shape opposition to opioid treatment policies.

The role of race and the media

In one experiment, we asked both white and black respondents to read a media profile of someone struggling with opioid addiction. We randomly varied aspects of the profiled person’s identity, including whether they were white or black, male or female, and whether they lived in an urban, suburban, or rural area.

We found that both white and black respondents were more supportive of funding treatment programs after reading a profile of someone who shared their racial identity. We did not find similar effects due to shared gender or geographic location.

Our findings are published in the March 2024 issue of a peer-reviewed journal Political behaviorsuggest that race remains the dominant factor shaping public attitudes toward opioid policy.

As a result, the media’s portrayal of people struggling with addiction may influence support for these policies. For example, evidence increasingly shows that black Americans have the same overdose rates grows faster than rates among white Americans, which may lead to a decline in public support for opioid treatment policies among white Americans. Media coverage that highlights how the opioid crisis impacts both white and black communities can avoid this backlash.

Finding common ground

In addition to race, our research shows that a person’s income and how opioid treatment policies are financed also influence citizen support.

IN an earlier study we conductedwe asked respondents whether they supported a $100 million state bill to respond to the drug epidemic. However, we randomly changed the account structure.

Half of our respondents had seen a “redistributive” bill that would pay $55 for residents with household incomes above the median income in their state and $5 for those below the median income. The other half of our sample saw a “needs-based” bill, in which respondents living in areas with high opioid overdose rates would pay $55 and those in areas with low overdose rates would pay $5.

Respondents generally preferred a redistributive bill to a needs-based bill. This shows that Americans are willing to do their part rather than leave struggling communities to foot the bill themselves.

While higher-income Republicans showed little support for the redistributive funding bill, lower-income Republicans supported it.

Given that Democrats of all income groups supported the redistributive financing bill, our research suggests the potential for a coalition between Democrats and lower-income Republicans. Policymakers could exploit this to introduce popular policies to address the crisis.

Construction processing

However, even with this broad support, funding may have narrow impact if there is no more capacity to build outpatient treatment centers and residential programs.

For example, addiction researchers have found that one of the most effective ways to respond to the opioid crisis is to quit medication-assisted treatment, such as methadone. Methadone treatment may require daily visits to the clinic for the first 90 days. Therefore, people seeking facilitate must have reasonable access to a nearby clinic.

We asked survey respondents whether they supported opening a modern methadone clinic, but randomly changed their minds whether the clinic was a quarter-mile from their home, or about a five-minute walk, or two miles, or about a 40-minute walk. While Democrats showed greater average support for the clinics, both Democrats and Republicans showed 15 percentage points less support when the clinic was just a five-minute walk from them.

Overcoming opposition

NIMBY attitudes from all sides of the political spectrum can hinder the construction of modern opioid treatment facilities, regardless of where they are proposed. However, we believe that novel policy solutions can facilitate prevent this.

State and local policymakers can take a cue from the federal government military base closure strategies, For example. Instead of voting on base closures one at a time — a strategy that will enable local opposition to block each closure — Congress must decide on a single package of closures determined by an independent commission. This combination equitably distributes the spatial impact of the policy.

Given that residents of cities like Philadelphia tend to theoretically support opioid addiction treatment centers, political leaders can leverage this support but require that the infrastructure be dispersed geographically – and not just in areas of the city where political opposition is less fierce.

Justin de Benedictis-Kessner is an assistant professor of public policy at the Harvard Kennedy School; Michael Hankinson is an assistant professor of political science at George Washington University.

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