Public Shaming of Drug Addicts Doesn’t Work, Experts Say
In October 2016, a photograph went viral of Erika Hurt, then 25, after she overdosed on heroin.
As CNN reported at the time, Hurt was parked outside a store in Indiana, a syringe in her hand. Her 10-month-old son sat in the back seat.
A customer saw Hurt and called police. The responding officers saved her life, reversing her overdose with two doses of Narcan.
One of the officers also took a photograph of Hurt in the midst of her overdose. The photo was released to the media by the police department without her knowledge.
Soon, reporters called Hurt to talk about the photo, which she learned had gone viral.
Hurt’s overdose is just one example of first responders photographing people having drug overdoses and distributing those pictures online.
“We are well aware that some may be offended by these images and for that we are truly sorry, but it is time the non-drug-using public sees what we are now dealing with on a daily basis,” wrote East Liverpool officials on that post.
However, experts interviewed by Healthline discourage the publication of photos depicting drug users overdosing.
They say such photographs only increases stigma against drug addiction, without doing anything to treat it.
‘Addiction is a brain disease’
In 2016, almost 20 million adults aged 18 or older — about 8 percent of the adult population — needed substance use treatments within the past year, according to the 2016 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration.
Despite the prevalence of substance use, much of the public views drug addiction as not “a disease of despair, but of moral failure,” explains Janie Simmons, EdD, founder and director of Get Naloxone Now.
“This idea that addiction is a moral issue is the dominant paradigm that we have in this country,” Simmons told Healthline. “And that paradigm perpetuates stigma, and we know that stigma keeps people from effective treatment more than it leads them to it.”
Addiction should be treated as a health issue, experts say.
“[Addiction] commonly leads people to do things they never imagined they themselves would do,” Collins told Healthline.
Regarding Hurt, he said, “Most people who haven’t had an addiction can’t imagine how someone can do what she did — to endanger herself, her son, and other people.”
Shaming ‘just does harm’
Many people who have drug addictions experience personal or professional consequences for their behavior.
In many cases, these people already feel shame or guilt about those consequences.
“When you are addicted, you’re constantly feeling shamed and humiliated and cut off from humanity and as though you are the lowest of the low,” explained Maia Szalavitz, author of “Unbroken Brain: A Revolutionary New Way of Understanding Addiction.” “Making you feel worse is going to make you want to use drugs, not want to stop taking drugs.”
People with addiction feel stuck and unable to do anything to help themselves.
Therefore, shaming or guilt-tripping them aren’t recommended by experts as good routes toward recovery.
“Basically, punishment for addiction behavior doesn’t work very well,” Collins said.
Punishment seems to be the intent of the overdose photographs being published by officials.
But the idea that addiction will cease because of punishment is misguided, says Szalavitz.
“Addiction is defined as compulsive behavior that continues despite negative consequences,” she told Healthline. “And humiliation is a huge negative consequence. If this stuff worked, addiction would not exist.”
Punishment is also one of the main ways our criminal justice system views addiction, Collins noted.
In the United States, people with substance use disorders often end up in prison because of things they did while on drugs, whether it was committing crimes or violating probation, he explained.
But while jail may act as a punishment for their specific crimes, it doesn’t address the person’s root problem of addiction.
That’s the same reasoning behind why experts don’t think law enforcement should publish photographs of overdoses.
“Police officers have been charged with dealing with this problem [drug addiction] as a legal issue,” explained Szalavitz. “Since they see it as a crime, and the whole point of criminalizing something is to stigmatize it, they figure this is going to work.”
In other words, continuing to view drug addiction as criminal behavior, rather than an illness, is failing the people it’s meant to help.
“I think [publishing photographs of overdoses] has more of that voyeuristic kind of, ‘Look at what these people are doing and how horrible it is,’” Collins said. “Rather than ‘Let’s educate people’ [that addiction is] an illness and recognize that it’s really common for people to do things they wouldn’t do if they weren’t actively addicted.”
Some people may also find 12-step recovery programs, like Narcotics Anonymous, helpful.
In his capacity as a psychiatrist who specializes in addiction, Collins said that when he works with people with addiction, he seeks to “foster their own agency in making wise decisions and help improve their motivation to make a change.”
‘Sobriety needs to be worked at’
Last month, Erika Hurt old CNN that she’s been drug-free since the day the photograph of her overdose was taken.
“This photo helped me look back,” she said. “It’s a constant reminder that sobriety needs to be worked at.”
In fact, Hurt shared the photograph of herself on her Facebook page on October 22, 2017, in celebration of her one year of sobriety.
“I’ve decided to repost the picture simply because it displays exactly what heroin addiction is,” Hurt wrote. “Also because I do not want to ever forget where the road of addiction has taken me. Little did I know that day, my life was about to change, drastically. Today, I am able to focus on the good that came from that picture.”
After the photograph of Hurt was taken, she was brought to a hospital and then to jail for violating probation from a charge in 2014.
According to CNN, Hurt was sentenced to six months of rehab in a facility that treated the underlying issues of her addiction.
She currently attends meetings for Narcotics Anonymous and meets with a sobriety coach and therapist.
“She’s resilient,” said Simmons. “And she uses the photo to remind her why she needs to continue to work on her sobriety. But I would argue that it was the overdose and what ensued that lead her to treatment,” rather than the publication of the image itself.
Indeed, the idea of hitting “rock bottom” is controversial.
“[Rock bottom is] a narrative concept,” said Szalavitz. “It’s a concept of sin and redemption, but it’s not a medical or scientific concept, especially when you’re dealing with a condition that is chronic for many people.”
“A lot of people claim a moment of shame or humiliation was their so-called ‘rock bottom,’ the reality is that the concept of rock bottom is flawed. And it’s flawed because it can only be defined retrospectively. So let’s say I get in recovery after a horrible OD video of me. Two years later, I relapse. Now where’s my bottom? Did my bottom have a trap door?”
Indeed, it’s likely the six months of court-mandated rehab helped Hurt in her recovery, Collins noted.
The photograph may have just been her “wake-up call” that she needed a change, he said.