The Makings of a SUD Stigma Reduction Campaign

Part 1 - The Plan

“Be kind, everyone you meet is fighting a hard battle.”

- Plato, or Philo, or Rev. John Watson

FIRST STEPS

Those of us in the “storytelling” profession immerse ourselves in the stories we tell. We watch for the unspoken, the nuanced, the hidden clues - to gain understanding. And then comes the formidable task of laying out all of the puzzle-pieces and reassembling them into digestible morsels - in words, or photos, or video. It's about creating a message that is both accurate and compelling, one that will ultimately resonate with the target audience.

Late in November 2018, I was approached by Imagine Hope Inc., to discuss the production of the creatives (photos and videos) for The Georgia Council on Substance Abuse www.georgiacouncilonsubstanceabuse.org proposed Substance Use Disorder (SUD) stigma-reduction campaign. It hit remarkably close to home. I am not a social worker, or a psychologist, or someone who works in the healing profession, but I have spent the better part of two decades, living with, and struggling with the substantial, life-changing, personal and collateral damage of my daughter's SUD. The damage and pain is staggering. It defines our lives.

The exuberance of childhood replaced with, “It hurts everyday, I just can’t get away from it."

There was a Time When These Things Were Unthinkable -

• Seeing my former straight-A student in shackles;
• comforting her friend's parents as they arranged for funerals;
• sending weekly payments to a prison account;
• accepting phone calls that begin with, "you are receiving a collect call from a correctional facility;"
• unexpectedly raising a grandchild;
• responding to his pain, “it hurts everyday, I just can't get away from it,”

- as I try to deal with my own.

In some cases indigenous knowledge is more relevant than the learned knowledge of the experts. And I believe that this is one of those cases.

STIGMA AND SELF-TALK

INDIVIDUALS WITH SUD

1) I’m an addict.

2) I’m no good.

3) If I get treatment, everyone will know.

4) I’ll stop tomorrow.

5) I’ll never do this again because, because, because . . .

Reality Check: SUD is a disease that needs to be treated like any other disease: minus the emotional burdens of stigma. Like any other illness, individuals suffering from SUD need to be allowed the freedom to talk about the disease and organize appropriate treatment.

Family of Individuals with SUD

1) We are not like her/him.

2) It’s just a phase.

3) What did we do wrong?

Reality Check: Families of individuals with SUD need to be able to accept that their

loved one has an illness and needs treatment. They need to be able to get emotional

support without dealing with the stigma associated with the disease.

Teacher's Treatment of Children of Individuals with SUD

1) He/she is not from a good family.

2) He/she is never going to amount to anything.

Children of people with SUD need to be treated with the same kindness and compassion

as other children that have parents with an illness. Instead, they are faced with

shame and humiliation, along with the logistical problems that come with being the child

of an ill parent. Very often, they are already working much harder to stay on track without

additional obstacles, shame, and emotional damage caused by the stigma associated

with the disease.

NEIL'S PROPOSAL - Stigma Reduction Campaign

I met with Neil Campbell, and her team at the Georgia Council for Substance Abuse

(GSCA) offices, and she laid out her plan. Initiate a recovery marketing strategy that

shares a positive message of hope through billboards and video stories. Along with the

SUD stigma reduction messaging, the campaign would also provide connections to recovery

resources.

The campaign “Georgia Recovers” was ambitious. For maximum exposure, theyplanned to place billboards throughout the state. The billboards would portray the “positive face” of local (peers) in recovery in order to support the scientific stigma reduction documentation. Using the billboards as both talking points, and as a tool to provide a URL link with a video message by the featured person in recovery. It would also provide information for recovery services and the Council’s 24-hour warm line. Q Optix Inc. was commissioned to produce the creatives (billboard photos and videos), as well as support the tag lines and messaging.

The GCSA was supported by the Georgia Department of Behavioral Health and Development Disabilities (DBHDD) dbhdd.georgia.gov. Under their guidance, the state was divided into six regions, which provide services in both the urban and rural areas of Georgia. Neil and the council planned to place a minimum of two unique billboard in each region. Two volunteers, local (recovery influencers) would be featured as the “face” of recovery for each region. It was a timely, yet bold move, considering that the recovery community had spent the better part of the past half century largely using the anonymity premise of the 12-step programs.

The Georgia Council was on-point and forward thinking in presenting and proposing the sweeping architecture for this project. Although the White House had held the first national drug policy reform summit in 2013 to start moving social norms from the “war on drugs” towards a public health forum, much of the general public, as well as the justice system still had not received the memo. https://www.drugabuse.gov/related-topics/ trends-statistics/overdose-death-rates. The ever-increasing death toll of the opioid epidemic coupled with the existing SUD crisis made it clear that the stigma that was impeding recovery needed to be addressed.

Support Evidence

In 2016, the National Academies Press published the book, Ending Discrimination Against People with Mental and Substance Use Disorders: The Stigma Change. Along with the book, SAMHSA also provided a Resource Guide, titled The Power of Perceptions and Understanding: Changing How We Deliver Treatment and Recovery Services.

- “Overcoming Stigma, Ending Discrimination.” https://www.samhsa.gov/sites/default/

files/programs_campaigns/02._webcast_1_resources-508.pdf

The publications were in response to a commission by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the United States Substance Abuse and Mental Health Services Administration (SAMHSA) to the National Academies of Sciences, Engineering, and Medicine. The resource guide listed important research that included Changing the Language of Addiction, a memo from former Director of the White House Office of National Drug Control Policy (ONDPC), Words Matter: How Language Choice Can Reduce Stigma; a training guide by the Substance Abuse and Mental Health Services Administration’s Center for the Application of Prevention Technologies (CAPT).

The document examines the role of language in perpetuating SUD (Substance Use Disorder) stigma, as well as an editorial in the American Journal of Medicine, which recognized the importance of language, and how it limited whether or not people sought treatment. These important studies and documents, all pointed to the same conclusion.

Substance abuse stigma was discriminatory, directly challenged recovery, and added an extra layer of problems in seeking and obtaining treatment. The Georgia Recovers Campaign was designed as an effort to canvas the entire state, including the larger urban areas like greater Atlanta and the vast rural areas in the south and the west, via the six regions defined by the DBHDD.

In order to have a diverse range of subjects and more global messaging, Q Optix set up a “call for entries” in each of the six regions, and then set a goal to interview approximately 10 people in each region. The interviews would be part of a regional video library, and a panel would make the final decision based on diversity and messaging. Tag lines would be pulled from the original interview footage and presented to the finalists for review. The final photos and PSA videos would be shot at a studio in Atlanta.

Stay tuned for Part II - The Process