One of the (many) ways this presidential election season has been unique is the candidates’ willingness to talk about the addiction crisis that plagues the United States and much of the rest of world. The catalyst for this discussion, unfortunately, is the opioid epidemic. According to the Centers for Disease Control and Prevention, opioid-related overdoses quadrupled between 2000 and 2014 and the problem shows no sign of easing.
The prevalence of opioid abuse is slowly changing drug addiction stigma. A 2015 New York Times article about the opioid crisis quotes the father of a young woman named Courtney Griffin who died after a heroin overdose. “When I was a kid, junkies were the worst,” Doug Griffin, 63, recalled. “I used to have an office in New York City. I saw them.” Noting that junkie is a word he would never use now, he said that these days, “they’re working right next to you and you don’t even know it. They’re in my daughter’s bedroom — they are my daughter.”
A growing number of celebrities and public figures are opening up about their struggles with addiction and subsequent recoveries, further reducing the stigma of addiction. After the death of music icon Prince, musicians came forward to talk about their own experiences with addiction. High-profile actors like Robert Downey Jr., Carrie Fisher and Matthew Perry are known as sober Hollywood figures.
Although the openness of celebrities and some families affected by addiction doesn’t necessarily reflect the public as a whole, it does speak to a shift that is slowly beginning to take place. While some continue to debate whether addiction is a disease, almost all experts recognize it as such. The Diagnostic and Statistical Manual of Mental Disorders, the definitive resource for diagnostic criteria for all mental disorders, recognizes drug and alcohol dependence as a brain disease. This classification is an important component of reducing addiction stigma by decreasing the perceived role of willpower in breaking free from the disorder.
In 1998, a survey conducted by the San Francisco-based Recovery Institute noted that, on average, fewer than 25% of respondents saw alcoholism as a disease. In contrast, a 2006 Gallup poll found that 76% of respondents viewed addiction to drugs and alcohol as a disease, although all of those respondents had a family member with a substance use problem. Fifty-five percent said a lack of willpower plays a major role in addiction.
Increased public awareness about the disease component of addiction is significant not simply in how people perceive those suffering from the disorder but also the kind of help they’re able to obtain. When the narrative around addiction is one of moral failing, it’s easy to suggest that people should be able to fix themselves. When addiction is rightfully seen as something akin to a mental illness, the layperson is more likely to support medical treatment. A 2014 study by researchers at Johns Hopkins Bloomberg School of Public Health compared how people view those with a mental illness as opposed to those suffering from addiction. Forty-three percent of respondents said people with a substance use disorder should not be given the same health insurance benefits as the general public. Only 21% felt that way about people with mental illness.
These studies also highlight how much further we have to go in reducing addiction stigma. “At one point, we had the stigma of leprosy,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “Nobody spoke about leprosy. We had a stigma of cancer at one point. There’s still a significant stigma with some of the mental diseases, but much less so than there used to be. But the one that’s lagging behind is addiction.”
While the stigma of addiction has decreased, it won’t be enough until anyone suffering from addiction feels comfortable seeking help.
“The more shame associated with drug addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need,” said Beth McGinty, study co-author and an assistant professor at Johns Hopkins. “If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction.”