In this holiday season of reflection and gratitude, as I think back over the last 15 months as an AmeriCorps member in the United Against Opioid Abuse campaign, I am indebted to and grateful for the individuals, organizations and agencies that have been so supportive and willing to collaborate, working to make a difference in our county in the battle against substance misuse. 

White County United Way:  Nikie Jenkinson and her board had the foresight to convene local agencies and individuals to ask the question:  What can we do about the substance use/opioid problem in our county?  Because of this conversation, White County United Way obtained a grant to bring the AmeriCorps United Against Opioid Abuse initiative to our county.  Thank you, Nikie and White County United Way board for taking the initiative to bring this program to White County.

First Responders, Government Officials, Criminal Justice Workers, and Public Servants at both the city and county offices:  Thank you for the time you spent taking this rookie under your wings and bringing me up to speed about your work.  You have offered guidance and wisdom. Thank you for the time you spent sharing your perspective on how drugs affect our county and what has been done, is being done and plans for the future.  Thank you for sharing statistics and information to provide an accurate picture of what is happening.  Thank you for graciously answering my calls and requests for information and data.  You have been most generous with your time and patience.

IU Health White Memorial Hospital:  Mary Minier and Melissa Dexter- Your partnership has empowered opportunities to provide information, meeting places, food, advice, and support for our work.  Your help with grants and funding has continued the momentum, and your structural, institutional, and caregiving capacity to serve our community will continue to be an asset for all who need assistance.

Local Media: To our local newspapers, thank you for publishing this column and sharing information with the community about the realities of substance use and its effect on people.  As William Cope Moyers indicated, “local journalism remains the single most important way to inform and influence people in a community.”  To our new friends at WLFI, thank you covering stories related to our work and helping us get the word out!  You always make us look good!

Local Nonprofit, Education, Faith, and Service Groups:  Thank you for allowing me to sit in on your meetings and share information about what we are doing.  Thank you for inviting me to speak with your members and share the many ways our work impacts the community at large. I am grateful to be a part of your groups. 

Members of the United Council on Opioids:  Thank you for joining the work and shouldering this task with us.  Your input, experience, guidance, and hard work is making a difference and creating positive change.

Families of those in substance use:  Thank you for sharing your stories and giving a face to the horror and devastation of watching a loved one self-destruct.  Thank you for your courage, perseverance and love for these dear ones. 

Friends in Recovery:  Thank you for your willingness to talk about your experience and offer hope to those still ensnared in addiction. 

The North Central QRT:  Thank you for coming to White County.  You are a breath of fresh air to us and offer a way to reach people who are struggling with substance use, opening the paths to recovery.

Those still struggling with substance abuse:  You don’t have to live this way.  There are people who want to help.  Don’t give up! Recovery is possible.  There is hope!  A great place to start is calling: 765-490-0381.  Someone will answer 24/7.  They have been where you are and can connect you to what you need.

To the readers of this column:  Thank you for your comments, encouragement and readership.  Your words have inspired me to continue. 

To Chad:  Thank you for planting this seed of an idea for these articles. 
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Mostly I am grateful for the friendships and relationships formed over the past 15 months.  It has been an exciting year of learning, processing and representing White County in this important work.  I have been deeply touched by your stories and experiences.  I am humbled and grateful for this partnership and collaboration.  Thank you for sharing this journey.

Last time, we discussed stigma related to substance abuse.  It is natural to look at someone else and make judgments. It is easy to assume we know about a person based on their appearance or actions.  But, are our perceptions accurate? Are we projecting our personal biases on to others?  Are these projections based on truth or opinion?

Stigma is powerful, complex and dynamic.  Stigma can cause problems for people in substance use that are bigger than addiction alone.  Stigma keeps people paralyzed in shame instead of hope and in isolation instead of community; defining a person by their addiction shuts them off from treatment and help.  Stigma can be internalized, so the person believes what stigma says about them.

Stigma not only affects the person, but also their family, friends, and even those who try to help them. They may face the same judgement, shame or barriers of the person who is in addiction. The stigma may come in words or thoughts. The underlying attitudes allies may face are: Why would you waste your time with THOSE people?  There is no hope for those in addiction. What did you do wrong to cause this?  How could you allow this to happen? 

One way to combat stigma is to recognize the stigma we hold personally.  We may not realize the beliefs, assumptions and thoughts we have that stigmatize others.  The Central East Division Addiction Technology Transfer includes the following questions in its Anti-Stigma Toolkit to help people consider their own levels of internal bias:  Do you believe that those who are struggling with addiction are weak, lazy or immoral? Do you believe some addictions are worse than others?  For example: is it worse to be addicted to illegal drugs than prescription drugs?  Do you believe that some people are beyond help, that they will never get better?  Do you believe that some treatments for substance abuse are better than others?  For example, do you believe that abstinence is better than medically-assisted treatment?  Do you believe that there is only one path to recovery, like a 12-steps program?

Another powerful tool in breaking stigma is to allow individuals and family members to tell their story. It is easy to stigmatize people we don’t know. The judgement and condemnation of stigma silences individuals and makes them fearful to share their journey. Taking the time to listen, understand, and recognize the person behind the label offers dignity and respect to someone who may have lost belief in themselves.  Seeing acceptance in your eyes may be a small encouragement that opens the person to the possibility of healing. 

Learn as much as you can about substance use, treatment, prevention, and recovery.  Share what you have learned. As you notice misinformation and inaccuracies in interactions with others, speak up and challenge mistaken ideas.

Don’t use stigmatizing language.  Calling someone a junkie or addict does not help them rise out of that life style. The old adage that sticks and stones may break my bones, but words can never hurt me denies the negative power of words that promote shame and judgment and keep a person in the hopeless state that crushes hope of recovery.
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Stigma never helps.  It can be broken and stopped.  When we recognize the power of stigma and its negative consequences we begin the change process of healing.  Addiction doesn’t have to be the end.  Treatment works.  Recovery is possible. If you or someone you know is ready to seek treatment, please call the Quick Response Team at 765-490-0381.

We often hear about stigma related to mental illness and substance abuse, but what does that really mean?
Stigma is a form of discrimination.  It includes making negative judgements and assumptions about others based on perceptions of who they are, what they look like, and what they do.  Stigma decides who merits dignity and respect and who does not. Stigma often means distancing yourself from those you deem unworthy. 
 
Stigma isolates and divides people into US and THEM. Stigma uses attitudes, words and actions to separate “innocent” people from bad ones. Where substance abuse is concerned, it separates junkies from those who deserve help and divides addicts from those worthy of resources. 

Stigma keeps families silent about their loved ones who struggle with addiction. Stigma says that if your child is involved in substance misuse, you are a bad parent. It silently accuses you of doing something wrong, even though a third of all families in the United States have a loved one struggling with addiction.

Stigma ignores the fact that addiction can happen to anyone, and that no one is safe.  As the fifth graders in the We are the Champions drama club said,” Addiction is an equal opportunity destroyer.”  No one is immune.  Stigma says It can’t happen to me or mine.

Stigma keeps communities from reaching out to those in need. Stigma means thinking that people involved in substance use just need to snap out of it and pull themselves up by their boot straps. It has us believing they are weak-willed and lacking self-control.

Stigma is the cashier who looks with disdain at people using food stamps.  Stigma is the receptionist who treats clients with tattoos and piercings differently those who don’t. Stigma is an educator who expects less of the children from “that family.”  Stigma is the medical professional whose words or actions communicate that the patient is a hopeless addict.  Stigma is smugly shaking your head, looking down on others, glad you are too smart, good, or virtuous for that to happen to you.

But when you listen to the stories of families and people involved in substance use, you begin to understand it could happen to anyone.  I hear stories of people who received prescription opioids, hated the way it made them feel, and refused to take more.  Perhaps they are the lucky ones. There are stories of others who upon that first opioid prescription, finally felt complete and that they had “arrived,” taking their first steps downward into substance misuse.  Stories abound of youth who experimented believing they were invulnerable and invincible only to become ensnared in the world of addiction. The stories of children whose families embraced the drug culture and never knew anything different are devastating, as they often become addicted to substances before they enter middle school.  Stigma is children whose lives are impacted by decisions that other people make for them. 

Stigma keeps people silent, isolated and shamed. Of the millions of Americans involved in substance abuse, only 10 percent seek out treatment.  According to the NAMI Cure Stigma website, stigma prevents people from seeking help because of shame or fear of judgement. Stigma says there is no hope for recovery.

Stigma points a finger offering blame and judgement, instead of compassion.  Stigma never helps. 
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Next time, how to combat stigma.