Tackling the opioid crisis through shame — or awareness

  | September 13, 2016

On September 7, a minivan nearly ran into a school bus in East Liverpool, Ohio, then drifted to the side of the road and rolled to a stop. Police found two adults in the front seat, overdosed and unconscious, their 4-year-old strapped into the car seat in the back.

On its city Facebook page, a graphic photograph and report from the local police department was posted of the couple and child, writing that “it is time that the non-drug using public sees what we are now dealing with on a daily basis.” The image went viral, launching a national conversation on the value of raising awareness versus the danger of shaming opioid abusers.

And as they read condemnations of both the overdosed adults and the police, some providers on the frontlines wrestled with a uneasy truth: that a wrenching public photo can both hurt and help in the war against opioid addiction.

“It’s not going to help addicts,” says Sue Meeks, a nurse who works in Athens, Ohio, about 100 miles south of East Liverpool. “But it is the truth. If we try to pretty it up, we will keep denying it. Pictures like this are a wake-up call.”

Meeks knows about addiction. Athens is another town on the state’s Appalachian border, where opioids and heroin have taken hold. With her colleague Pamela Born, manager for Athens Medical Associates, a local OB/GYN practice, Meeks cares for many pregnant women addicted to opiates.

Meeks and Born say that stigma and judgment may discourage patients from seeking care early in their pregnancies, when it will help the most.

But they also understand the power of denial, and the importance of raising awareness — even among physicians — that opioid addiction crosses every geographic and socio-economic line. Born recalls a conversation with a physician from a more affluent area of the state.

“He said he was glad he didn’t have these problems in his office. And I said, ‘If you think you don’t have this problem, then you’re not asking your patients the right questions,’” she says.

When they saw the photo, Born and Meeks say, their first thought was for the child, his privacy and plight. It is not his job, after all, to spread word of the opioid crisis.

Yet Born, who has family in law enforcement, says she also empathizes with the police who posted the photo.

“I can see it both ways,” she says. “They’re frustrated, seeing stuff like this over and over. And they’re worried about the next generation. It would be so sad to come across something like that.”

And Meeks felt compelled to post her own response on the East Liverpool police Facebook page, trying to turn the conversation from condemnation to empathy.

“This is more common than you think,” she wrote. “Everyone has a family member who is addicted, you just don’t know it. It is humiliating for the addict, but it’s not who they really are, it’s the drug. This the face of addiction.”

For healthcare providers, Born and Meeks say, the challenge is finding a balance between sharing stark truths about a public health crisis and providing nonjudgmental care for its victims.

“Mothers don’t feel that humiliation when they come into Athens Medical Associates,” says Meeks. “It’s a safe place.”

“I don’t know what the real answer is,” Born says. By helping mothers get clean and deliver healthy babies, she says, “all I know is that we’re just trying to save one life at a time. And if we can save two, then that’s what we do.”

Gale Pryor is a senior writer for athenaInsight.

Tackling the opioid crisis through shame — or awareness