A video report released last week by WCVB portrays "methadone mile"--the stretch of road in the South End of Boston, Massachusetts, where the effects of the nationwide opioid crisis are on full display. Running by Boston Medical Center, one of the city's main hospitals, the street is home to a number of drug treatment facilities, a homeless shelter, and, yes, a methadone clinic.
The report shows us repeated pictures of people walking down the street, under the influence of drugs, suggesting that "addicts" are rampant in the area. It portrays drug users as a faceless horde who threaten the area and who litter the streets with drug use paraphernalia.
As Dean of the Boston University School of Public Health, I pass by this stretch of road every day. I do not see what the report sees. What I see are people with a range of medical conditions related to drug use. I see someone's mother or someone's child who has had the misfortune of developing a drug use related issue, and who could benefit from help.
Drug use is a real problem in this country, and around the world. Nearly five percent of total years of life lost globally are attributable to alcohol and illicit drug use. There are 185 million illicit drug users around the world, and the primary contributor to this burden of addiction is opioid dependence. We need to find real solutions to this ongoing tragedy. Unfortunately, sensationalist coverage like last week's story does nothing to solve the present crisis. Indeed, it deepens it. By portraying drug users as dangerous "others", who are a threat to be isolated and marginalized, WCVB deepens stigmatizing portrayals of drug use that moves us further away from solutions to this problem.
I have written on this issue before. In work published several years ago, I studied the health effects of discrimination on drug users--the kind faced every day by this marginalized group. When people are discriminated against, it affects their physical wellbeing. Discrimination and stigma have been associated with heart trouble, low birth weight, mental illness, and overall poor quality of life. When we treat drug users as less than human, when we promote--intentionally or not--the image of those who use drugs as being somehow beyond the pale, we not only condemn them to face their disorder alone, we are actively undermining their health.
Unfortunately, the language of the WCVB report is as dehumanizing as the images they chose to show. The term "addicts" contributes to the stigma of drug use. An "addict," like a "junkie," is not a person; not a son, daughter, or friend. An addict is something else, something that exists on the fringes of society; easily discarded, or worse, not even thought of at all. In public health we have worked to replace this word with terms that better reflect the reality of people living with addiction--that they are, in fact, people; people who are dealing with a disease that can, with the right help, be treated and cured. It is for this reason that Dr. Richard Saitz, a professor at our school, traveled to a meeting of the International Society of Addiction Journal Editors in Budapest last year, and convinced these leading editors to stop using the words "abuse" and "abusers" in their journals (not counting the titles of these publications). Like "addict," these words lead to discrimination, and real harm.
Words matter. Images matter. We begin to solve this problem only when we stop seeing drug users as anything other than what they are: members of families, members of communities, people we cannot cast aside. Rather than spread stigma, we need to embrace forward-looking approaches that favor treatment over incarceration. We must stop viewing this as a matter of crime and punishment, but rather of illness and proper care.
Here in Massachusetts, there are encouraging signs that this view is beginning to take hold. In Gloucester, Police Chief Leonard Campanello began the Angel program, designed to steer drug users away from prison and toward the help they need. It works like this: if someone with a drug problem walks into the station and says she needs help, she will not be arrested, she will be taken to the hospital and paired with a volunteer who will help to guide her through the process of recovery. It is a program based on empathy, respect, and a keen awareness of the potential of every drug user to become, in time, a former drug user, and to leave "Methadone Mile" far behind.