I have spent the majority of my life working to understand addiction from both a personal and professional perspective. As someone who grew up in the beautiful state of West Virginia, where the opioid crisis is thick and prevalent in every system, I am often thankful opiates were not available when I was a kid. I would likely be a statistic. West Virginia has a poverty rate of 17.9% and recently ranked in the bottom four states for household income. This does not surprise me one bit, because it was my reality. Poverty creates a desperation and also increases all sorts of trauma, I guess you can say poverty is trauma. All the stereotypes that you might have about the beautiful people from West Virginia, was in some part my reality. In addition to the struggles, there was a lot of beauty like childhood friends and families that believed in a village sense of care, mountain camping trips that still fill my dreams and make me smile, Friday night lights on the football field, and wild and wonderful journeys that filled me with hope—thanks to all the great WV teachers!
My early experiences definitely continue to color my adult years, where my fight is about creating bridges for those struggling with addiction, mental health, and who come from socioeconomically disadvantaged homes. I’m mostly sending messages of hope and offering solutions for clinical intervention and community response because I know life can change, mine certainly has. I know my past is why I have a deep drive to help with addiction community response and why I became an addiction and mental health counselor and researcher many moons ago because this fight was my fight in a roundabout way. I now fight for my kids’ future. My pedigree has provided me with grit and resilience like no other—just ask my husband or anyone from my past. My clients have this same grit and resilience, this is why I always believed in their recovery even when very few people accepted their path of recovery or when the odds were stacked against them.
I sat with clients who struggled with Opioid Use Disorder in Medicated Assisted Treatment (MAT), as a counselor, addiction specialist, and clinical supervisor and wondered why this treatment path felt so undercover? At that time (early 2003-2011), MAT had no wind in its sails, but clients were still coming by the hundreds and thousands and I was witnessing them get better and return to a life of recovery quickly. The wind is starting to flow under the MAT sails and more doctors and health professionals are getting educated, providing and recommending care along a continuum. The day to day stigma that clients still have to face just to be in treatment or receive health care, in general, would be overwhelming to most people trying to navigate a system feeling deathly sick. My hat goes off to all those who are health care advocates for those struggling (mothers, fathers, aunts, siblings, recovery specialists). I vowed to fight against this stigma and today as an addiction specialist, professor, and researcher I am doing just that with my work. The stigma associated with addiction was and still is the main barrier to individuals gaining access and feeling hopeful about their treatment choice.
Stigma has many different characteristics and target variants according to Pescosolido and Martin and it can be provider-based, policy-related, public practice, or self-induced. Below are some stigmas I have witnessed that I would like to begin to unpack:
This list is not exhaustive or categorized but it is a quick list and everything on it I have sadly witnessed. I would welcome your conversations or stories about anything on this list. Or better yet, let me know any stigma that I missed or a counterargument. This story is based on my own experience in the field of addiction treatment and does not represent any data-driven report.
Let’s keep the list going so we can start tackling it one community at a time.
To all those on a path of recovery and living a life of wellness, health, and purpose, I honor your chosen path of recovery and recognize that there are multiple paths to the top of this mountain. Keep on keeping on!