Social Media Perpetuates Stigma Surrounding the Opioid Epidemic
Recently, news organizations and social media channels have increased exposure of devastating images of addiction, especially photos and videos of people overdosing or near-death, sometimes with their children nearby. In several cases, community leaders and first responders posted or shared these pictures and videos, believing that public exposure to these images will help address the problem.
But imagine this response to a different medical emergency: A mother who is significantly overweight falls unconscious on a train, her son crying out something about her “sugar.” While others rush to help, another watches the drama unfold and captures it on his phone. He zooms in on the stricken mother, zooms out to the terrified child. It is intense, heartbreaking and scary. A life-and-death moment captured on camera to be shared with his social media world.
Would a bystander really do this in response to a diabetic crisis? Perhaps. But, it is much harder to imagine this video or one involving a heart attack, epileptic seizure, or asthma attack being shared by others whose jobs involve helping those who are sick and improving the health of their community.
And yet, when it comes to addiction, this practice seems to be gaining momentum as an acceptable response to witnessing parents overdosing on opioids in the presence of their child. Or at least considered forgivable – a frustrated reaction to an out-of-control problem. But, if these leaders or helpers sent out videos of an inconsolable child and a critically ill parent with a respiratory, endocrine, or cardiovascular disease, wouldn’t the public outcry be focused on the person releasing the video, rather than the afflicted person?
So why is it acceptable when the videos feature people with addiction?
Two long-standing problems surround addiction and impede effective responses to the opioid epidemic: stigma and ignorance. The fictional scenario above involves a seriously ill woman with obesity, the one medical disorder that is arguably more stigmatized than the disease of addiction. And yet, it is much harder to imagine that train video being distributed by a community leader in hopes of scaring people into eating less or shaming someone suffering from obesity into losing weight for the sake of their children.
The stigma of addiction will remain strong because some of its symptoms result in real risk or harm to others. But more of the stigma of addiction, which is also true of obesity, comes from the public believing that these different, life-threatening medical conditions result from poor willpower and that they can be changed solely through motivation, effort and self-control. Research has proven these prejudices to be untrue.
The truth is most young people who have unhealthy diets or use substances do not go on to develop the diseases of chronic obesity or addiction. Genetic and environmental factors influence how our bodies and brains process food and substances and more powerfully determine chronic obesity and addiction than choice or willpower. Yet, the general public still dismisses these facts and blames the victim. The reality is that expecting sick people to change by judging, shaming, arresting, or admonishing them rarely works and sometimes worsens their condition.
In the case of opioid addiction, expecting people to recover without the help of medication-assistant treatment can be deadly. People with opioid addiction not only suffer the stigma of the disease, but also the stigma of its treatment. Methadone, Suboxone, and Vivitrol are the most effective treatments, but remain highly stigmatized, underutilized and insufficiently covered by insurance.
The second impediment to stopping the opioid epidemic is ignorance, which is deeply entwined with stigma. Community leaders and first responders have justified promotion of these horrifying images as a way to increase public awareness. They hope they will help prevent people from using opioids or encourage others to seek treatment, including the person whose medical condition is being publicized without their consent.
Decades of research and expert opinion conclude that scare tactics do not work. Worse, these videos may lead to even greater suffering by shaming and humiliating the victims or re-traumatizing those who have lost loved ones to addiction. These videos do nothing positive to promote lasting change or improve the health of people suffering with addiction or the well-being of their families.
Opioid overdose reversal medication followed by long-term maintenance treatment and continuous care monitoring are needed for those people most seriously addicted to opioids. Not videos. And most definitely, not the judgment, shame, humiliation, and ignorance of those who may be trying to help, but are only adding to the stigma and suffering.
Samuel A. Ball, PhD
Dr. Ball is the President and CEO of Center on Addiction