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Social Stigma Is One Reason The Opioid Crisis Is Hard To Confront

Hope and Pete Troxell lost their daughter Alicia to an opioid overdose in 2017.
Jennifer Schmidt
Hope and Pete Troxell lost their daughter Alicia to an opioid overdose in 2017.

There are many reasons why the opioid crisis is so hard to confront. One of them is social stigma. It often extends beyond users themselves, to their families.

Hope and Pete Troxell live in Frederick, Maryland. Last year, their 34-year-old daughter Alicia died after overdosing on fentanyl – a synthetic form of heroin. She was seven months pregnant. Hope says before Alicia's death, they often felt the weight of judgment.

"So many people look at these [people] that are addicted to drugs, they call them every name in the book. They're junkies, they're thieves."

Pete Troxell says even some relatives have stayed away.

"Nobody from my immediate family has called us, stopped in [to] say 'How are you doing? Can I help you?'" he says. "Not one phone call, not one visit from my immediate family."

Researchers say one reason there is so much stigma around drug use is that many people view addiction as a moral weakness. Leo Beletsky, a public health researcher from Northeastern University, says stigma enters the political discourse "around personal responsibility versus coddling and enabling."

He says the argument over whether drug users should simply "just say no" distracts us from what needs to be the top priority: saving lives.

"Look, if you want the person to take personal responsibility, you have to give them the tools to do that. And unless you revive the person who is dying, they are not going to take personal responsibility for anything."

But the political discourse is just part of it. The language of addiction is also implicitly pejorative. Urine tests—and users--for example, are called clean or dirty depending on whether they test negative or positive for drugs.

After Alicia died, the Troxells put up a small memorial to their daughter in the backyard. Hope Troxell says few people have come by to visit.

"People just stay away. And I often think, well, do they think I have some kind of a disease? That's what it feels like."

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Shankar Vedantam is the host and creator of Hidden Brain. The Hidden Brain podcast receives more than three million downloads per week. The Hidden Brain radio show is distributed by NPR and featured on nearly 400 public radio stations around the United States.
Parth Shah is a producer and reporter in the Programming department at NPR. He came to NPR in 2016 as a Kroc Fellow.
Jennifer Schmidt is a senior producer for Hidden Brain. She is responsible for crafting the complex stories that are told on the show. She researches, writes, gathers field tape, and develops story structures. Some highlights of her work on Hidden Brain include episodes about the causes of the #MeToo movement, how diversity drives creativity, and the complex psychology of addiction.
Tara Boyle is the supervising producer of NPR's Hidden Brain. In this role, Boyle oversees the production of both the Hidden Brain radio show and podcast, providing editorial guidance and support to host Shankar Vedantam and the shows' producers. Boyle also coordinates Shankar's Hidden Brain segments on Morning Edition and other NPR shows, and oversees collaborations with partners both internal and external to NPR. Previously, Boyle spent a decade at WAMU, the NPR station in Washington, D.C. She has reported for The Boston Globe, and began her career in public radio at WBUR in Boston.