Perceived agency and paternalism: Increasing support for people with substance use disorder

Substance use disorder (SUD) is a public health and economic crisis in the United States, yet funding for recovery services remains limited. We designed an experiment to examine whether presenting people in SUD recovery as having high or low agency impacts how much donors give in support of SUD recovery, and how donors allocate donations across paternalistic and non-paternalistic aid. Participants in our experiment could donate up to $100 to paternalistic and non-paternalistic SUD recovery support (aid to a recovery house and direct aid to those with SUD, respectively). We found that participants donated about $40 to SUD recovery, of which two-thirds was allocated to recovery houses (paternalistic aid). Both the low and high agency treatments increased recovery house donations, and the high agency treatment significantly increased overall donation amounts. In a follow-up experiment, we tested two additional treatments to rule out alternative explanations (besides agency) for our treatment effects, namely empathy towards residents (tested for by eliminating the description of the residents) and perceived recovery housing effectiveness (tested for by using an agency neutral description). The follow-up experiment replicated the main findings and the agency neutral treatment weakly increased overall donations in support of SUD recovery. These findings suggest that donors have strong preferences for providing paternalistic rather than non-paternalistic aid when supporting a stigmatized population. They also suggest that communicating characteristics of a stigmatized population may help increase donations, particularly if beneficiaries’ positive characteristics (such as agency) are emphasized and donors have the option to provide paternalistic aid.