The Stigma: Then & Now

When Tony Kushner’s Angels in America originally debuted in 1991, HIV/AIDS was considered a death sentence. It also slapped with a stigma that isolated and ostracized those with the disease, as well as their families. The same type of stigma is happening now with substance abuse and the opioid epidemic.

So begins Sandeep Kapoor’s STAT News article "'Angels in America’ again: It’s time to humanize addiction." The opinion piece, timed to coincide with the Tony Award-winning play’s Broadway revival, reveals how we’ve evolved since then.

“Since 1991, we have learned how to treat, humanize, and support those with HIV/AIDS so they can live long and productive lives,” writes Kapoor. “How that happened is a complicated story. But the first step was as simple as it was bold: recognize and address the stigma.”

Kapoor then reaches a very logical conclusion:

“The less we stigmatized AIDS patients and their loved ones, the more we were able to focus on the disease. It’s time to do the same thing with substance use, misuse, abuse, addiction, and the current opioid epidemic.”

Kapoor goes on to call for a few key ways to fight America’s opioid epidemic.

Let's Change Our Language

“The way we talk about this health crisis is deeply problematic, [so] let’s change our language. Words matter, and they can make or break opportunities to empathize, partner, and support. Just as we don’t call people struggling with obesity “fat,” let’s shift our verbiage to humanize addiction. The message that dependence on chemical substances is not a character flaw but a chronic illness will shine through in words, demeanor, and empathy. Instead of using dehumanizing words, use proper, person-centric terminology — people dealing with addiction. They deserve compassion and treatment.”

Let's Advance Training

Let’s also train “health care professionals to spot signs of addiction earlier and treat it before it’s too late. At the moment, most U.S. education programs for health professionals have little curricular time dedicated to substance use, addiction, dependence, and their implications. This lends itself to a process where clinicians’ social primers, biases, and stereotypes surpass the science of this disease.”

“If health care providers continue to view addiction only through the lens of extremes — encountering it when patients come in at the height of a crisis, seeking medications, or suffering from an overdose — then we won’t be motivated to change our approach. Too many lives have been affected by addiction for us to remain in an uneducated, dis-compassionate state.”

Not "The" Epidemic; "Our" Epidemic

Kapoor says it’s time to realize we aren’t “facing the opioid epidemic, but our opioid epidemic. If you don’t suffer from addiction or aren’t related to someone who does, it’s easy enough to dismiss addiction as someone else’s problem. It’s not. With so many lives at stake, healing is dependent not only on physicians and patients and families but on all of us demanding better compassionate solutions.”

And then again finds parallel with the AIDS Crisis.

“Many Americans who wanted to believe they knew no one with AIDS suddenly realized that the disease was hitting closer to home when they learned that a friend, family member, or loved one had been struggling silently with it for years. We’re seeing the same pattern with addiction, and we must break it.”

Call for a New Angels in America

Like Kapoor, we here at Recovery Boot Camp advocate to erase the stigma of addiction. And we too believe the way we talk about addiction is integral to the way the disease is perceived. We also applaud Kapoor’s analogy with Kushner’s seminal Angels in America, as well as his common sense call to action. We hope there’s a new Kushner out there, somewhere, who can do for addiction what the playwright did for AIDS. And we can come to treat the disease with the compassion and empathy that those afflicted deserve.

(Note: Boston Globe Media's STAT is focused on finding and telling compelling stories about health, medicine, and scientific discovery. We would like to wholeheartedly thank them for their service.)

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