Column: Coping with the crisis — Eliminating stigma

Would you get treatment if you’re diagnosed with cancer? I sure hope so. As we know, the earlier you get help, the easier it is to recover.

So why is it that so many people refuse to seek help for mental health and substance misuse? Like cancer, the longer you wait, the worse it gets. And like cancer, care and support are crucial to recovery. Too often, what holds people back is the social stigma. 

According to Dr. Nora Volkow, director of the National Institute of Drug Abuse, progress has been made over the years in reducing the stigma of some mental conditions such as depression. Public education and the widespread use of anti-depressant medications have contributed to this change. But the stigma of substance misuse remains. The public and many in the health care system see a patient’s drug or alcohol problem as their own fault and, worse still, as a result of a character weakness. 

In fact, substance misuse disorder (which comprises many substances) is a brain disease. At its worst — addiction — changes in the brain’s structure and functioning may lead to impairment in all aspects of a person’s functioning. While there may be a genetic component to who becomes addicted, there is certainly no moral failing that leads someone in that direction.

While alcohol remains the most widely misused drug, nearly 40,000 deaths per year are attributed to opioids. Due to the highly addictive nature of opioids, recovery from addiction is extremely difficult.  And the stigma associated with opioids is tremendous. According to a paper from the Bloomberg American Health Initiative at Johns Hopkins University, 78% of Americans believe that people who are addicted to prescription opioids are themselves to blame, and 72% believe these people lack self-discipline. The tragic irony here is that for so many people addicted to opioids (and often later to heroin) it all started through a doctor’s prescription intended to minimize pain.

If society believes these things about substance misusers, imagine how these people view themselves.  Self-stigma refers to the negative attitudes and internalized self-shame that people have about their own condition. And those with self-stigma may be even less inclined to seek help.

Even though mental health and substance services are confidential, it is important that we, as a community, work to eliminate the stigma of asking for help, and that we support those in need.

On August 31 of this year, Shelter Island held a vigil honoring those in our community who died from overdoses. That emotional evening underscored how vital it is for people to feel safe from judgment when they need help. It also called for friends and neighbors to reach out and embrace those who are struggling, rather than turn a blind eye. 

As a follow up to that important event, a group of Shelter Island professionals from the school, town, and community, under the leadership of Police Chief Jim Read and School Superintendent Brian Dolger, Ed.D., is now working together to organize new prevention programs. Prevention programs must begin with school-age children and continue through adulthood. This is a problem affecting all ages, ethnicities, and socio-economic groups. Therefore, our entire community will be targeted for education on prevention and how to find help.

If you know someone who is struggling, it may be more comfortable to pretend that the problem doesn’t exit. But that only leads to more shame. Discussing the issues candidly and without judgment is the first step toward help. True, many misusers may not be open to the conversation. But many are and would be grateful.

We are fortunate that Shelter Island has a social worker, Lucille Buergers, dedicated to assisting residents with any kind of problem. Her services are free and confidential. She can meet with people in person, on Zoom, or, when indicated or preferred, can refer off-Island. Ms. Buergers can be reached at [email protected] or by calling 631-749-0302.

In the meantime, we ask everyone to raise their awareness of this nationwide problem by joining in the substance misuse community programs and events that we hope will become as important as the Halloween parade and Christmas festivities.

After all, people’s lives depend on it.

Nancy Green is a member of the Shelter Island Health and Wellness Alliance along with Lucille Buergers, Jim Colligan, Laurie Fanelli, Trish Gallagher, Jackie Kanarvogel,  Bonnie Stockwell, and  Ryan Sultan, MD.