South Africans Viewed All Substance Users Negatively, but Saw Cannabis as Less Dangerous Than Alcohol

A survey of 868 South Africans found high stigma toward all substance users, but cannabis users were rated as significantly less "dangerous" than alcohol users, and gender influenced whether help or coercion was offered.

Sorsdahl, Katherine et al.·BMC psychiatry·2012·Preliminary EvidenceCross-Sectional
RTHC-00621Cross SectionalPreliminary Evidence2012RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Preliminary Evidence
Sample
N=868

What This Study Found

Researchers presented 868 people with vignettes describing substance use involving alcohol, cannabis, methamphetamine, or heroin. Respondents held equally negative views across substances, with one notable exception: cannabis users were rated as significantly less dangerous than alcohol users.

Gender influenced responses: people were more likely to offer help to women who used alcohol but more likely to suggest forced treatment for men. Respondents who scored higher on their own substance use measures held more negative attitudes toward substance users. Black African respondents were more likely to offer help.

Key Numbers

868 respondents surveyed. 8 vignettes across 4 substances and 2 genders. Cannabis rated significantly less dangerous than alcohol. People with higher own substance use scores held more negative attitudes toward other users.

How They Did This

Street-intercept convenience sample of 868 South African adults. Each respondent received one of 8 vignettes varying by substance (alcohol, cannabis, methamphetamine, heroin) and protagonist gender. Attitudes were measured using standardized attribution scales. The ASSIST measured respondents' own substance use.

Why This Research Matters

Stigma is a major barrier to seeking treatment for substance use disorders. Understanding how stigma varies by substance type, user gender, and cultural context helps design more effective anti-stigma campaigns and treatment outreach.

The Bigger Picture

The finding that cannabis was perceived as less dangerous than alcohol in South Africa mirrors patterns found in other countries, suggesting this perception may be widespread. The gender disparities in attitudes (help for women, coercion for men) have implications for how treatment services are designed and promoted.

What This Study Doesn't Tell Us

Convenience sampling via street intercept is not representative of the broader South African population. Vignette-based responses may not predict actual behavior toward substance users. The study was conducted in one country with a specific cultural context around substance use.

Questions This Raises

  • ?Do these stigma patterns affect who actually seeks treatment for substance use?
  • ?Would anti-stigma campaigns reduce the gender disparities in how substance users are treated?
  • ?Why did people with higher own substance use hold more negative views of other users?

Trust & Context

Key Stat:
Cannabis was rated significantly less dangerous than alcohol
Evidence Grade:
Convenience sample survey with vignettes; provides attitudinal data but cannot establish representative population views.
Study Age:
Published in 2012. Public attitudes toward cannabis have continued to shift globally as legalization debates progress.
Original Title:
Negative attributions towards people with substance use disorders in South Africa: variation across substances and by gender.
Published In:
BMC psychiatry, 12, 101 (2012)
Database ID:
RTHC-00621

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do people view cannabis users differently than other substance users?

In this South African sample, cannabis users were viewed with similar overall negativity as users of other substances, but were rated as significantly less "dangerous" than alcohol users. This suggests a partial distinction in how the public perceives cannabis versus other drugs.

Were men and women substance users treated differently?

Yes. Respondents were more likely to offer "help" to women who used alcohol but more likely to suggest "coercion into treatment" for men. This gender difference has implications for how treatment outreach is designed and may reflect broader societal attitudes about who deserves compassion versus control.

Read More on RethinkTHC

Cite This Study

RTHC-00621·https://rethinkthc.com/research/RTHC-00621

APA

Sorsdahl, Katherine; Stein, Dan J; Myers, Bronwyn. (2012). Negative attributions towards people with substance use disorders in South Africa: variation across substances and by gender.. BMC psychiatry, 12, 101. https://doi.org/10.1186/1471-244X-12-101

MLA

Sorsdahl, Katherine, et al. "Negative attributions towards people with substance use disorders in South Africa: variation across substances and by gender.." BMC psychiatry, 2012. https://doi.org/10.1186/1471-244X-12-101

RethinkTHC

RethinkTHC Research Database. "Negative attributions towards people with substance use diso..." RTHC-00621. Retrieved from https://rethinkthc.com/research/sorsdahl-2012-negative-attributions-towards-people

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.