Publicly Shaming Drug Users Does Not Help The Heroin Epidemic

Photographed by Jessica Nash.
In case you haven't heard, the United States is dealing with an epidemic. Close to 10 million Americans abused opioid drugs in 2012, according to a study released in June by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). And between 1999 and 2014, overdose deaths from opioid use quadrupled in lockstep with a fourfold increase in the number of opioid painkiller prescriptions, according to the CDC.

"In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills," according to the American Society of Addiction Medicine. And 80% of heroin users started out by misusing prescription opiates.

These are all facts that can be useful in understanding the problem, and how we might eventually solve it. A lot has been said about what we should do. Among the suggestions: increasing use of the life-saving overdose drug naloxone, rethinking the way doctors prescribe painkillers (these happen to be two main goals of the Comprehensive Addiction and Recovery Act, which passed with bipartisan support in Congress in July), and expanding access to medication-assisted treatment and therapy. Other, more radical ideas include opening self-injection sites or prescribing medical-grade heroin so those in recovery who have been resistant to other treatments can safely manage their addictions.

One thing that is absolutely not helpful, though: posting graphic photos of people in the middle of overdoses to Facebook. Unfortunately, that is exactly what officials from East Liverpool, Ohio, decided do earlier today. City officials posted photos of a couple who appear to be unconscious, along with a police report, and a "graphic content" warning to the City of East Liverpool Facebook page. A small child sits doe-eyed in the backseat. (Refinery29 is choosing not to link directly to the post.)

"The city administration works hand in hand with our men in blue to combat this epidemic and together with the law director we have made the decision to release the attached," the post reads. "We feel it necessary to show the other side of this horrible drug. We feel we need to be a voice for the children caught up in this horrible mess... The poison known as heroin has taken a strong grip on many communities not just ours, the difference is we are willing to fight this problem until it's gone and if that means we offend a few people along the way we are prepared to deal with that."

Rightfully so, the post did offend people — in multiple ways. Many reacted with disgust, expressing concern for the child in the backseat. Others reacted with criticism of the post itself. "[Y]ou just totally sabotaged their chance at having a successful rehabilitation and integration back into a normal, healthy, productive life," one commenter wrote.

Research suggests that ending the stigma of substance abuse disorders is important for treating the abuse itself because it can keep people suffering from these disorders from seeking treatment out of fear. One of the ways this stigma manifests is our insistence on thinking of addiction as a moral failing, rather than a disease. Making an example out of two addicted people on what may be the worst day of their lives is not a way to "fight this problem," because all it does is increase this stigma.

"Shame and stigma are a large part of what drives many people who use drugs underground and away from people and resources that can help," adds Tessie Castillo, the communications and advocacy coordinator for the North Carolina Harm Reduction Coalition. "It is important to raise awareness about overdose and to teach people about the good and bad that drug use can cause, but we can do that through educational campaigns and voluntary story-sharing by people who are ready to tell their truth, not through posting personal and stigmatizing photos or information about people without their consent."

The American Society of Addiction Medicine characterizes addiction as "a primary, chronic disease of brain reward, motivation, memory and related circuitry" — yet, addiction remains the only "primary, chronic disease" we feel justified in shaming suffering for. Until we can stop doing that, we likely won't get very far in solving the problem.
This post has been updated to include comments from Tessie Castillo of the North Carolina Harm Reduction Coalition.

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