Approximately 88% of adults view opioid overdose deaths as a very serious problem with high agreement across political groups, according to a national survey conducted by Weill Cornell Medicine researchers. However, political differences over who is responsible will shape the country's next phase of drug policy.
Historically, Americans have viewed people who use opioids as primarily responsible for the overdose crisis, with conservatives especially emphasizing personal responsibility for addiction. However, the new study, published Jan. 16 in JAMA Network Open, demonstrates that across the political spectrum, more people are placing responsibility on pharmaceutical companies, as well as individuals.
This finding was a little surprising. Addiction is so stigmatized that we were anticipating that responsibility would still center on people who use opioids. Pharmaceutical companies, however, seem to be front of mind, perhaps because lawsuits highlighting their role in the crisis have received a lot of news coverage."
Dr. Beth McGinty, first author, chief of the Division of Health Policy and Economics at Weill Cornell and co-founding director of the Cornell Health Policy Center
Dr. McGinty, along with senior author Dr. Colleen L. Barry, inaugural dean of the Cornell Jeb E. Brooks School of Public Policy and co-director of the Cornell Health Policy Center, and their colleagues conducted a 2025 national web survey of 1,552 adults, exploring their perceptions of opioid overdose deaths and how views differed by political ideology. Overall, the sample was demographically representative of the national population of Black and non-Hispanic white adults.
The study results come as U.S. opioid overdose deaths decreased nearly 27% decrease from 83,140 in 2023 to 54,743 in 2024, according to the Centers for Disease Control and Prevention. More conservatives and moderates thought that people who use opioids should be responsible for reducing overdose deaths. In contrast, more liberals felt pharmaceutical companies should be liable for reducing overdose deaths. "Measures such as lawsuits against pharmaceutical companies and investing settlement funds into programs that address addiction and overdose may gain more traction," Dr. McGinty said.
Demonstrating the social stigma of addiction, about 38% of all survey participants were unwilling to have a person with opioid addiction as a neighbor, while 58% were unwilling to have someone with opioid addiction marry into their family. Desire for social distance was substantially higher among conservatives compared with moderates or liberals.
Past research shows that stigma may hinder evidence-based policies for prevention and treatment of opioid use disorder, including expanded treatment access, harm-reduction programs and non-punitive approaches.
"The findings suggest that addressing the overdose crisis should remain on the policy agenda, but different views across political ideologies on responsibility and stigma may underlie preferences for future actions to curb overdose," said Dr. McGinty, who is also the Livingston Farrand Professor of Population Health Sciences at Weill Cornell.
Moving forward, Dr. McGinty and her team are examining public support for a relatively new policy approach: state laws requiring substance use treatment programs to offer medications for treating opioid use disorder as a condition of licensing. "While a lot of state programs are historically based on an abstinence approach, these medications are the most effective treatment for preventing overdose," she said.
This research was supported by the Robert Wood Johnson Foundation (grant #797554).
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