The recent The Surgeon General’s Report on Alcohol, Drugs, and Health calls for a cultural shift in how we think about addiction. For too long, many people have viewed addiction as a moral failing. This stigma has created an added burden of shame for people with substance use disorders which makes them less likely to come forward and seek help. It has also prevented us from investing in prevention and treatment.
Addiction to alcohol or drugs is a chronic but treatable brain disease that we must approach with the same skill and compassion with which we approach heart disease, diabetes and cancer. It requires medical intervention, not moral judgment.
Substance use can “hijack” the normal function of the three main circuits in the brain involved in the reward system, learning, stress, decision making, and self control. Healthy adults are usually able to control their impulses when necessary, because these impulses are balanced by the judgment and decision-making circuits of the prefrontal cortex. Unfortunately, these prefrontal circuits are disrupted in substance use disorders. The result is a reduced ability to control the powerful impulses toward drug use despite awareness that stopping is in the person’s best long-term interest.
One of the recommendations of President Trump’s recent opioid commission was the suggestion that the government battle stigma by partnering with private and nonprofit groups on a national media and educational campaign similar to those launched during the AIDS crisis.
Fay Zenoff, executive director of the Center for Open Recovery, a Bay Area nonprofit, is promoting an idea that has been considered radical in addiction circles. She and other advocates suggest that instead of hiding in the shadows, people in recovery admit that they are in recovery and celebrate their success.
21 million Americans suffer from substance abuse and approximately 175 die from overdoses every day. Ms. Zenoff says that if it was safe for more people to say, ‘I’m in recovery,’ more people would ask for help. Stigma is most effectively dispelled through openness.
Other nonprofit groups such as Faces & Voices of Recovery in Washington, D.C., Facing Addiction in Connecticut, and Shatterproof in New York are also encouraging the 23 million Americans in recovery to be more vocal. The Center for Open Recovery ran posters on San Francisco Muni buses, featuring vibrant people of all races with the tagline “This Is Recovery.”
The onset of the AIDS epidemic was met by Act Up marches, the AIDS quilt and posters which made people more sympathetic to people suffering with AIDS and shifted people’s understanding of the disease. At this point, substance misuse kills more Americans every years than AIDS did at its peak in 1995.
In spite of the Surgeon General’s report defining addiction as a “chronic neurological disorder,” many people still refuse to accept that addiction is a brain disease. According to Facing Addiction, one in three American households have a family member in active addiction, in recovery, or lost to an overdose.
Maybe if we started talking openly about addiction with our family members, coworkers and friends, it would no longer be our dirty little secret and we could break the cycle of stigma.
For more information, please look at The Surgeon General’s Report on Addiction: https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf
And “Let’s Open Up About Addiction and Recovery” by Laura Hilgers