This post was originally published on September 27, 2016.
I’m a guy who, within the first few seconds of waking up, is already scrolling through my text messages and Facebook news feed. Until a few weeks ago, I didn’t care that many experts say it’s pretty much the worst way to start your day. Then something happened that changed my mind and I haven’t done it since. The reason? A Facebook friend posted a gut-wrenching photograph of two adults, both slumped in their front seats, clearly having overdosed on heroin. If you’ve been under a rock, here it is (shudder).
To say the image is haunting does a disservice to the word “haunting.” It doesn’t need a caption. And then my sleepy eyes drifted to the backseat, where a 4-year-old boy is looking toward the camera with a thousand-yard-gaze. You could see so much contained in that single frame: the robbed innocence, the death-mask bliss of the adults, the lives ravaged by our country’s opioid epidemic. The photograph swiftly sparked a firestorm dividing critics into two camps. For some people, the real crime isn’t with substance abuse problems—it’s the crime of sharing it with the world. And then there are those who say the photograph is exactly what we need to see right now, exposing our country’s addiction problem for everyone to see. No matter the reaction, it calls into question the cost of keeping the stigmas associated with drug addiction alive and well.
“Not Animals At a Zoo”
A piece at The Huffington Post argued that the photograph, released by the East Liverpool Ohio Police Department, amounts to discrimination. More than that, it’s just unnecessary. “People do not need to see a couple experiencing a drug poisoning incident to realize the horrors of the opioid and opiate crisis in this country,” the op-ed said. “The imagery, while alarming, is punitive and blaming in nature.” The article says that the number of people who die from accidental drug overdoses per day “has climbed to over 160 a day”—as if to say the opioid epidemic is so commonplace that we should accept it as normal. The number should be dramatic enough on its own.
“People with substance use disorders are not animals at a zoo, and are certainly not a cog in the voyeuristic machine that is often modern day America. Is what happened awful? Of course it is—there was a baby in the car. Was it wrong that the parents did such a thing? Again, of course it was,” the HuffPo article goes on, recalling old “War on Drugs” campaigns from the 1980s and 1990s that put the faces of drug-addicted kids front and center on magazine covers. The article argues that this is simply more of the same—and just as ineffective, claiming those covers did little to undo the drug epidemic of years previous.
“This is not stigma; this is not political correct culture gone wrong; this is, and should be labeled, discrimination against a segment of the American population,” the article says. “To call it anything but discrimination is to argue on a faulty premise. When will we take a stand? We are not chattel, second class citizens—we are human beings. If you must, punish the couple for child endangerment—but do so AFTER you have given them an opportunity to recover from the bio-psycho-social illness which they are contending with. That is an appropriate response; a human response.” Many critics, however, believe that giving faces to nameless data and statistics is the solution to the crisis.
“A Benign Motive”
An article in Forbes takes a completely different position to the East Liverpool PD’s photograph, observing that the photo got the exact reaction it deserved. As writer Sally Satel puts it: “The police wanted the public to benefit from the shock of seeing how addiction harms children and communities.” It even includes the police department’s chilling caption: “It is time that the non-drug using public sees what we are now dealing with on a daily basis.” The photograph does one thing very effectively: it doesn’t just stigmatize drug-addicted adults—it crucifies them. And, as Satel suggests, rightfully so.
In all the ways the HuffPo article argues against stigmatizing adults, the Forbes piece explores all the ways those stigmas should actually be reinforced. Those who think the photograph is just what we need to see, should also consider why stigmas will never fully go away. Instead of believing that eliminating stigmas will automatically drive addicts into treatment—especially those who are afraid of broaching the subject with their employer—a lot of the problems will simply solve themselves. “For every employee who is ashamed to tell his boss or fears some kind of reprisal, another may decide to stop on his own or get help precisely because he wants to avoid the embarrassment of failing at the job or of revealing the problem to his boss. Shame, or the prospect of experiencing it, can be an effective deterrent.”
The Forbes story also unpacks the notion that if we simply eliminate stigmas around addiction, it’ll improve the types of treatment available to people. Not true, the Forbes story says. “If addiction is seen simply as another medical condition, specifically as a ‘brain disease,’ this will foster public and political will to fund drug treatment. Again, a benign motive, but more wishful thinking than sound prediction.” It even believes that it’ll simply be driven by the “using population” which are whites and the middle class. Eliminating stigmas won’t speed up anti-addiction medications nor will it suddenly improve an addict’s self-worth, either. One clinician said their patients “came for help only because they ‘couldn’t stand’ themselves anymore…because they have acted in ways that challenge their sense of themselves as good parents, good workers, responsible individuals.”
Between the Lines
It’s important to realize that even supporters of the photograph’s release don’t believe that stigma paves a perfect road for recovery. Quite the opposite, Satel told Forbes: “I agree that efforts to get help should surely be immune [from stigma]—those who need help should be urged to get it. I encourage 12-step group attendance for those who find it helpful and want formal treatment to be accessible, respectful, and competent.” The biggest key is to get former addicts to become “visible symbols of responsibility” and “de-stigmatize themselves,” rather than relying on a slogan. Still, there’s a distinct sense that stigma has a place and value in our society.
“Stigmatization is a normal dimension of human interaction; it has a civilizing effect on communities, and is often the basis of the anti-drug messages we give to children,” the Forbes piece concludes. “There is nothing unethical—and everything natural and socially adaptive—about condemning the reckless and harmful behaviors that addicts commit.”
It’s less important whether you agree with the photo’s release or not. It’s more about what it represents about social stigmas and how it factors into conversation that’s occurring about the opioid epidemic that’s currently corroding our cities. Whether the photograph is the perfect weapon against drug abuse or just another wholly ineffective awareness tool that’s as dehumanizing as it is insensitive, doesn’t matter. Given the arguments of both sides, the photo is clearly worth more than a thousand words when it comes to the war on our country’s opioid epidemic.