Welcome to the seventh edition of the bimonthly newsletter from the West Virginia Department of Health and Human Resources (DHHR), Office of Drug Control Policy (ODCP).
If you know someone who would like to receive future issues, please email Dora.L.Radford@wv.gov.
One of the most amazing things that has been discovered in the past few decades of addiction research is how and why people become addicted to substances. We now know that exposure to a substance begins to change the brain's physical structure over time. The impulsive areas of the brain take over from the areas that control personality and the ability to make informed choices and evaluate risks. Research has also revealed that addiction has nothing to do with being a "good" or "bad" person and that developing a Substance Use Disorder (SUD) can happen to anyone.
Though an individual sip of alcohol or use of a drug is a choice, when that behavior becomes uncontrollable and the impulses are too hard to resist due to changes in the brain, it becomes a SUD. This new understanding of the nature of addiction and its effect on people requires us all to change our approach to individuals suffering from this disease. Comparatively, in the past depression was thought to be a defect of character born of a weak will, and people suffering from depression just needed to “cheer up.” Now we know that depression is a brain disease that responds positively to medication and treatment.
When society gives up on people suffering from an SUD, they tend to give up on themselves. We call this negative and non-factual view of others stigma. Stigma ultimately becomes a deadly self-fulfilling prophecy – people are excluded, treated poorly, and looked down upon for their SUD. This negative perception can cause SUD to worsen and prevent individuals from getting appropriate treatment.
We also know that there is hope. With the absence of substances, we see the physical changes to the brain return to normal. As we educate the public on stigma and expand our understanding of addiction, more people than ever are getting into treatment and entering long-term recovery. These individuals reverse the cycle of cynicism and are living proof that recovery is always possible and happens every day. The Office of Drug Control Policy is committed to educating our fellow West Virginians on reducing stigma around the disease of addiction as well as advancing evidence-based strategies to help individuals live fulfilling, self-directed lives.
What is Stigma?
Since 1999, more than 840,000 Americans have died from a drug overdose, and preliminary data from the CDC suggests that 2020 will be another record-breaking year for overdose fatalities. As part of the multi-faceted approach that is needed to address this epidemic, we must combat the stigma attached to addiction. Stigma is rooted in the belief that addiction is a personal choice, a lack of willpower, and a moral failing. Stigmatizing attitudes are common among the general public and within professions whose members interact with people with addiction, including health care professionals.
Stigma manifests in negative stereotyping, labeling of people, status loss, and discrimination. Public stigma is the persistent negative attitudes and beliefs that lead to societal rejection of people with substance use disorders. Public stigma contributes to and is perpetuated by structural stigma, which materializes as discriminatory practices and policies at the institutional level. Self-stigma happens when people with a substance use disorder internalize these negative views. These forms of stigma are not unique to addiction, but addiction stigma is unique in the way that the opioid agonist medications methadone and buprenorphine for opioid use disorder are stigmatized independently of a person experiencing addiction: not only are people with opioid addiction stigmatized, the evidence-based treatment for opioid use disorder is also stigmatized.
The Governor's Council on Substance Abuse Prevention and Treatment: Public Education Subcommittee
In 2021, the Governor’s Council on Substance Abuse Prevention and Treatment formalized the Public Education Workgroup as an official Subcommittee of the Governor’s Council. The subcommittee is focused on addressing three goals to promote education and reduce negative beliefs (stigma) in order to promote treatment and recovery for substance use disorders. The subcommittee has taken an inventory of current training and educational opportunities across the state to develop an online repository and to identify any gaps. Gaps may include communities or populations that are not being targeted, lack of access to training in a particular region, a lack of evidence-based or validated training on a topic, or a lack of resources for training including trainers or associated costs. The subcommittee is then tasked with promoting available training and identifying sustainable methods for addressing these gaps. The subcommittee is also focused on ensuring integrated and consistent statewide messaging when it comes to media, marketing, outreach, and educational campaigns. It is necessary to challenge negative messaging and beliefs with evidence based and effective messaging. Resources are often scarce, therefore, it is important that opportunities are not duplicated but rather supported and expanded upon to reach all West Virginians.
“Changing our language may seem like a small step, but I’ve been told by countless family members of someone who is struggling with an addiction how they recognized who they could talk to or confide in based on the language they used. I know West Virginians love showing up for their neighbors, but the loved ones of those struggling and even the caregivers or children of those with a substance use disorder often face secondary stigma and shame. To address this disease and pull people out of the shadows and into treatment, we need to reduce the deadly effects of stigma and replace them with facts and the necessary support for treatment.”
Individual struggling with the disease of addiction. Individual not yet in recovery. A person with a substance use disorder.
Drug-addicted baby/ Drug-baby
Infant who was neonatally exposed. Infant with prenatal exposure. Infant experiencing withdrawals.
Ambivalent, Pre-contemplation stage
Not-blaming; talking about the stages of change; offers change rather than label
Substance Use Disorder
Drug of Choice
Drug used/Drug of use/ Commonly used drug
It's not a "choice"
Treatment is the goal
Treatment is an opportunity
Reduces judgement and failure
Abstinence] … is the only way
Each individual takes a different path towards recovery or becoming drug free
Offering opportunities and acknowledging the individual process
Drug free/Free from illicit drugs or medication
Stigma-free language not associating dirtiness with drug use
Choosing to use drugs
Disease of addiction
Medicalize the problem
Recurrence/Return to Use
The word relapse brings a lot of baggage
Individual in recovery process
Using abstinence language precludes those using medication assisted treatment
Medication Assisted Treatment
MAT may be part of the process for some
There is no such thing as rock bottom
Waiting for a "huge" crisis to intervene is dangerous and deadly
Combatting Stigma by Making Naloxone & Training More Accessible
Dr. Susan M. Bissett, President, WV Drug Intervention Institute
West Virginia experienced a 45% increase in the number of overdose deaths in 2020. In fact, according to a report released by the United States National Office of Drug Control Policy (NODP) last month, more West Virginians died of drug overdoses last year than in any previous year on record—an estimated 1,275 deaths in 2020.
As I shared in an opinion piece published in the Charleston Gazette-Mail last year, one way to combat these dismal numbers is to save lives by using Naloxone, a medication that can reverse overdose. While once only prescribed by doctors and dispensed by pharmacists, this life saving drug is now readily available without prescription to anyone who may want it. You do not need to live with or know someone in active addiction to have Naloxone on hand. Despite these facts, stigma about Naloxone is pervasive in our communities and many persons who should carry it or have it their homes are without this life-saving medication.
"I have witnessed addiction all around me though I’ve never personally struggled with it. I’ve seen addiction break the hearts of so many people and often questioned how things ended up that way. In high school, I realized it would be very easy to access drugs and even easier to become addicted to them. I witnessed my friends try drugs at a party and then never quit them. Those same friends ended up in jail and/or hospitals because of drugs. It could’ve easily been me. I don’t know why I didn’t fall into addiction and I don’t know why my friends did. One friend in particular had a very similar upbringing to mine. Why did she end up addicted to drugs but I didn’t? It was then that I realized addiction does not discriminate. It doesn’t care if you’ve had the perfect upbringing or if you’ve grown up in less then desirable conditions. It doesn’t care if you’re a kid or if you have a family that depends on you. Addiction can happen to anyone. For so many, it’s difficult to see the person behind the addiction. But that person is someone’s whole world. That person is not just a statistic to their family and friends. I felt like this photoshoot would open the eyes to people who tend to look down on those in active addiction. Through this photoshoot, I hoped to bring attention to the problem that is sweeping through our nation and even more so in our community. Addiction does not have to be the end. There are so many options and so many people willing to help you recover. I wanted to do this photoshoot so that people would realize that there is hope. I met so many wonderful men and women and learned so much about addiction and the process of recovery. One of the ladies said it best when they said, “where this is life, there is hope.”
The ATLAS Survey recently opened – addiction providers can help our patients and loved ones find the information they need by submitting it for your facility! Contact the ATLAS Help Desk to get your facility’s link: https://survey.alchemer.com/s3/6296448/ATLAS-Help-Desk
June 8: MAT Waiver Training with Emphasis on Treating Pregnant and Parenting Women
Medications for Addiction Treatment (MAT) for Substance Use Disorders involves a combination of medications that targets the brain, and psychosocial interventions (e.g., counseling, skills development) aimed at improving treatment outcomes. Research shows that medications and therapy together maybe more successful than either treatment method alone. This interactive MAT Waiver Eligibility Training provides comprehensive, evidence-based information that aims to help health care professionals determine the most clinically appropriate approach and informs individualized treatment decisions. This training will be particularly useful for providers of Opioid Use Disorder (OUD) treatment in pregnant and post-partum women.
June 22, 23, and 24: West Virginia Peer Recovery Support Services Conference
Welcome to the 2021 Peer Recovery Support Services Conference - Advancing Peer Services in West Virginia. During this FREE three-day virtual event, you’ll learn more about the role of peer recovery support services specialists from national and locally recognized speakers. You will increase your intervention skills by practicing methods such as motivational interviewing and developing skills necessary to coach others. You will also hear more about ethical guidelines and boundaries for peer specialists. This conference is designed for you. We challenge you to explore the complex issues associated with building and working in a peer recovery system. We encourage you to explore new partnerships and liaisons. We invite you to enjoy this time together with your peers. We are so glad you’re here.
The purpose of this newsletter is to highlight successful responses to substance use disorder (SUD) across the state. If your organization would like to share the work being done in your region for upcoming newsletters, please email Jessica.N.Smith@wv.gov.
Our mailing address is:
1 Davis Square, Suite 100, East, Charleston, WV 25301