here. Perfect. All right. Well, good morning, everyone. Thank you all so much for joining us. My name is Chelsea Kamara. I am Inupiaq descendant and I'm a social worker by training and I now serve as a training and technical specialist with the Opioid Response Network. For those of you who may not be familiar with the Opioid Response Network, we are grant funded by SAMHSA to provide free training and consultation to communities across the country. Today, this session will be addressing stigma and substance use disorder treatment. This session is being recorded and will be available for you to view in about two weeks. Before I introduce our presenter for today's session, I'd like to open our session by sharing a land acknowledgement with you all. Our work intends to reach the addiction workforce in the Northwest TOR region. This includes Alaska, Idaho, Oregon, and Washington. This region rests on the ancestral homelands of the indigenous peoples who have lived on these lands since time immemorial. Please join us in support of efforts to affirm tribal sovereignty and in displaying respect and gratitude for our indigenous neighbors. We respectfully acknowledge and honor all indigenous communities, past, present, and future. Thank you all. So with that, I would like to introduce our presenter for today's session, Stephanie Stillwell. Stephanie is a registered nurse with a diverse background in the healthcare industry, including addiction treatment and healthcare consulting. Her passion is promoting community health and wellness and disease prevention. Stephanie works creatively to bridge the gap between the healthcare system, individuals, and the community. She's facilitated multiple local and statewide coalitions throughout the state of Alaska. Stephanie is an Anishinaabe woman from Lac La Coeur First Nation in Ontario, Canada. And with that, Stephanie, I'll go ahead and pass it over to you. Awesome. Thank you. Hi, everybody. Again, it's really nice to be here. And as Chelsea said today, I'm going to talk to you all about stigma and substance use disorder treatment. So I've got a few additional slides before we dive in. These are just some acknowledgements and information about the Opioid Response Network. And all right, it's time to actually dive in now. So this is our first session of four that we're going to have regarding substance use disorder. So today we're going to focus on stigma. And then over the next couple of weeks, we're going to do a deeper dive into understanding trauma-informed practices and how we can really incorporate making some changes into our work to better serve the people that we're working to help. Then we're going to really look at the brain science of addiction and what's really happening in our brain and our bodies when substances enter into our bodies. And understanding how they impact our brain really helps us to understand the different treatment options for both addiction and opioid use disorder treatments in particular. So again, today, we're really going to dive into stigma and explore some of the misconceptions about substance use disorder, talk about the impact that stigma has for both people that we're serving and others. We're going to talk about the importance of language and how we can really improve patient outcomes just by simply changing how we speak about substance use disorders. So again, the relationship between substance use disorder and stigma is really complicated and complex. And even though over the course of time, how we look and view substance use disorder has really shifted, there's still a lot of work that needs to be done in this to really get folks to truly understand that substance use disorder is an actual disease that impacts our brain and it's not a personal failing or a choice. And that stigma really is just a harmful misconception about someone or a group of people. And in this particular situation, it's people who are suffering or struggling with something called substance use disorder. And there's a lot of different types of stigmas that people who are living with substance use disorder or in recovery from substance use disorder face. And so we'll kind of dive into the different types of stigma that people face today. But one of the most important ways and effective ways to reduce the stigma really does involve just simply looking at the language and how we speak about substance use disorder. So that's what we're going to dive into today. So just, you know, I know we're going to try to rush through this presentation a little bit, but so in your heads or if you want to come off mute, you're welcome to. But what are some of the types of things that come to mind when you hear somebody that is going through cancer treatment or has survived cancer treatment? What are some of the ways people describe those individuals? Sometimes we hear them referred to as warriors or they're strong-willed, they're survivors, it's an empowering experience, they're resilient. You know, these things all sound really, really empowering and positive and ways that people are really uplifted through their treatment and recovery from cancer. Whereas when we think of somebody who might be going through treatment for substance use disorder or are in active addiction, some of the words that we hear people use to describe even today are things like I'm dirty or they're abusers or they're misusers or whatever other negative kind of connotation that folks might have. So why is that? What makes these two conditions so differently in how people think and treat those individuals who are going through the treatment process? The different language that's used to describe the individuals with cancer versus with substance use disorders really just highlights the major issue of stigma in our society. It shows us that there's so many differences in how people perceive different health conditions. So this of course can be rooted in the historical stigmatization of viewing addiction as a moral failing rather than understanding that it is a chronic health condition and an addiction or a disease that affects the brain. This also can be attributed to how the media continues to portray substance use disorder or how courts continue to criminalize drug use. So there's definitely been a push in the right direction in the recent years. There's been a big movement to change how we talk about substance use disorders and of course people like you being trained today and learning how to provide better treatment and care for these people who are struggling and going through this. It's just really important to remember that both somebody who is going through treatment for cancer and substance use disorders are both impacted by significant health challenges and they both deserve to be treated with the same level of respect, empathy, and support. So I really enjoy this slide because it really highlights that there is a problem when we talk about someone being clean versus dirty. When someone says a person is clean, it implies that at one point it was dirty. So of course this has a negative connotation. Again, so somebody who referring to people who are in recovery or who've had a negative toxicology screen as clean, that again means that at one point they were dirty or impure. So this just continues to perpetuate that harmful stigma. I really enjoy this quote here. When co-workers ask me if a client is clean, I will be like, yeah, there was no detectable mal-order and their hygiene was good, their clothes were laundered, and they were dressed whether appropriate. So just kind of a really fun way to kind of dismiss that stigmatizing language that somebody tried to offer. So stigma around substance use disorder comes in multiple different forms and shapes how we, how people see and deal with substance use disorder. So there's stigma from kind of multiple angles that people end up having to face. So there's stigma from within. This is like when somebody who is going through substance use disorder treatment or has, is an active addiction, they feel a lot of blame or feel ashamed of themselves because of their substance use disorder. They start thinking that they're failures because of what society says. So the self stigma makes it really hard for people to ask for help when they need it. There's stigma from the community. This is people outside in the community. This could be friends, family, or neighbors that might actually look down on somebody, you know, or people who use medication for addiction treatment might have stigma against them from even people within their own recovery community because of, you know, biases and stigma that says that medication used for recovery isn't real recovery. And sometimes we've seen this in indigenous communities too, where some folks might not be able to participate in certain ceremonies because they are not using or they're not remaining completely abstinent and they're using medication. Thankfully, this isn't as big of an issue anymore as it has in the past, but there's definitely still some stigma in that, in the, from the community. Stigma from clinicians. This is a, this is something that's still occurring today. In some healthcare settings, even healthcare providers can be biased because of stigma. So they might treat patients differently if they have a substance use disorder, or some clinicians just feel, might feel that their patient isn't going to be, their treatment isn't going to be effective or whatever. So this is just different types of stigma that still exists within the healthcare and clinician settings. And then there's stigma from, you know, outside from society. So this stigma is external and it involves the public's perception of addiction and substance use disorder. So this one's often influenced by what people are seeing in the media or conversations with other people. Of course, the media tends to sometimes perpetuate some of the negative stereotypes about substance use disorder and addiction and use more derogatory language. So this is really not helping to shed positive light on, on folks who are, who have substance use disorder. And so this can really impact the public's opinion of substance use disorders, as well as even impact policy decisions or lawmaking, how our government or other programs choose to support treatment and recovery programs. So really what this really does boil down to is just a lack of understanding about the science of addiction and failing to recognize that this is a chronic medical condition that actually does require long-term care, just as somebody who has diabetes or has hypertension or cancer. So again, the impact that stigma has is huge. It's far reaching and damaging. Stigma can diminish the belief that addiction or substance use disorders is a valid treatable health condition that in itself can cause people to refrain from seeking help. It can definitely be a barrier to finding employment, housing, relationships. There's stigma that discourages that public support for treatment funding. Again, sometimes there's stigma from insurance companies not wanting to cover certain things for substance use disorder treatment. There's definitely more punitive laws. So there's just a number of different ways that people feel the impact that stigma has today. And so it's really important for us to really look at how stigma and where stigma is impacting others, so that we can help change things and make it easier for people to both receive the care and treatment that they require and deserve. So this is just some simple, easier, instead of saying this, say that. So some suggestions on how to really make an impact by just changing a few of the ways that we speak about the disease of addiction or substance use disorders. So instead of saying things like an addict or an alcoholic or a junkie, it's a person who uses drugs or someone who has alcohol use disorder or substance use disorder. Again, we want to stop saying clean or dirty. We say they're not actively using or they're substance free or they're in recovery. I know a former addict or an addict, we want to switch over to saying a person who is in recovery and a habit is actually a substance use disorder. So we also want to start to think about, you know, things like abuse versus saying use or misuse. Again, drug habit would be opioid or substance use disorder. What's another one on here? OK, yeah. Clean drug screen instead of clean versus dirty. It's your positive or negative for substance use or a positive or negative toxicology screen, urine screen. Another word is relapse. We're really working to try to change how this how we're using this word, because really in the diagnostic criteria for substance use disorder, one of the kind of symptoms is kind of the recurrence of symptoms. So often having, you know, times where they, you know, we would consider it a relapse if they were sober for X amount of time and they, again, then they used their substance of choice, which really is just a recurrence of their symptoms, a recurrence of the disease. And when it comes to babies that are impacted, we don't want to say babies that are born addicted. We want to talk about babies who are born with a neonatal abstinence syndrome or an opioid dependency, but maybe babies first, people first in our language. So specifically when it comes to Indigenous Native people, the ongoing impacts of colonialism really continues to devastate communities today. So oppression, marginalization, impacts of historical and intergenerational trauma over time led to significant health disparities among Indigenous people, which, you know, comes to disproportionately high rates of substance use disorder. And unfortunately, Indigenous folks are also less likely to seek treatment for mental health issues compared to non-Indigenous people. This is due to things like stigma, which is a huge barrier to accessing care. And then just generally a widespread lack of awareness about the history and effects of colonialism just really does impact the issues. So this actually has resulted in a lot of times Indigenous communities kind of being unjustly blamed for their own health disparities, which kind of relates to or brings us to the quote, drunken Indian stereotype. So this is, you know, just a really harmful stereotype and a complete misunderstanding of what kind of led to this disproportionate impact from drugs and alcohol in the Indigenous communities. So it's really just important because we need to really address on a larger scale some interventions and campaigns and things that we can do to really provide education to folks to understand more Indigenous mental health and trauma informed care, better support our Indigenous patients and population. Later on in our series, we're going to do a deeper dive into medications for addiction treatment, how it works, why it works and why it is the gold standard, medically speaking, for treatment for opioid use disorder. But for today, I just really want to highlight the importance of the language and how we speak about something and the impact that it can make. So in the past, we've called MAT medication assisted treatment, but now we call it medications for addiction treatment or medications for opioid use disorder. What it is not, it is not replacement therapy or substitution therapy. So we really just want to make sure that we're using the correct terminology when we're speaking about this treatment option. Again, when we move into our sessions that dive deeper into the science of substance use disorder and medications for addiction treatment, you'll really gain a better understanding of how these medications work that will ultimately help you understand and reduce any stigmas that you might have had moving into that as well. But it's not substituting one drug for another. It is the FDA approved medication is the safest option for treatment of opioid use disorder. People with opioid use disorder are 50% less likely to die when treated long term with either buprenorphine, which is Suboxone or methadone. Research proves that medication for addiction treatment, this is another where an older slide, decreases opioid use, opioid related deaths, and even decreases criminal activity and infectious diseases. So this really does bring improvement to patient survival, long term treatment retention, and just really helps folks live their life to the fullest. And you'll find out why in our series session on MET. Again, another myth is harm reduction programs are enabling folks when in reality, harm reduction programs reduce the risk taking behaviors and increase engagement in substance use disorder treatment. So we have a whole section session on this as well. But it is not the gateway to addiction. It is not to support them in their addictions. It's really a harm reduction is all about meeting people where they're at and offering them steps to get any help and services they need at any time. And when it comes to stigma, again, we do find that I mentioned, but it's within the recovery community themselves sometimes. So 12 step meetings, 12 step is a great way for people to find support. But oftentimes, we're still finding that people in 12 step groups often don't view MET people who are using medication for their treatment as in recovery. So it's really important to find out which support groups are really supportive of medications for people who are in recovery, so that they don't experience this stigma in those groups as well. And, of course, we're really hoping to continue to educate folks and help people understand that people who do use medication for as part of their treatment process are in recovery as well. So just some additional suggestions and reducing stigma and how to change kind of the language around things is, you know, I think it's really important for folks to be aware of the stigma. So just some additional suggestions and reducing stigma and how to change kind of the language around things is, you know, I think it's really important for folks to be aware of the stigma. So just some additional suggestions and reducing stigma and how to change kind of the language around things is, one is changing our language and terminology. So again, we want to use that first person language, because that acknowledges the person first. Number two is educating people. We want to provide as much education to everyone as we possibly can, really highlighting some of the reasons why people might develop substance use disorders, which we'll dive into over this series as well. And just really helping to get some education out about all of the things related to substance use disorder. We want to personalize substance use problems, meaning having people who have experienced and have lived experience in addiction or with substance use disorder, talk about things. Have just more people kind of from different backgrounds sharing their experiences so that people can find something relatable in other people. So really just helping people understand that substance use disorder can happen to anybody and anybody also can recover from substance use disorders. Again, the same thing, similar, we want to tell positive stories. So show the positive face of people with substance use disorders rather than just the negative. So again, this is kind of countering that media stigma that we talked about earlier. We want to try to highlight the positives as much as possible, because we need to show that we do recover, that we do have hope that we can do these things, and countering some of the negative stereotypes and things that are still very much alive in the media. Again, share your story. Super important because sharing our personal stories really does help us to reduce some of those negative attitudes and stereotypes. It encourages others to seek help, encourages others to just open up, and it can be a real healing experience for people who are also in recovery to help to share their story. Knowing they're also helping other people. So share, share, share. There's a lot of great examples of storytelling and sharing out there as well. Okay, I know that we're trying to end a little bit early today, so I don't need us to kind of come off and do this discussion, but I want you to consider this as kind of how if we were to apply some of the same stigmas to another condition, what that would be like. So imagine that you go to the hospital, you're having severe chest pain, and they tell you, hey, you're having a heart attack. But they tell you, this is your fault because of your choices. You did this to yourself, and you were denied treatment because of that. Then they give you a list of cardiologists and cath labs to call once you get home, even though you're still hurting and actively having a heart attack. You're only given some aspirin if you agree to go to counseling so that you can learn how to, you know, not make the same choices that got you here. And then you're kicked out of the hospital if you come back with more chest pain. So, you know, think about how that would feel and why we can, you know, why we wouldn't, as a healthcare system, treat somebody in a heart attack that same way, but somebody who might come in with substance use disorder, alcohol use disorder, might be treated that way. So just, you know, think about the differences in that and why we need to start viewing, you know, substance use disorder and addiction in the same light as we would a heart attack or diabetes or any of the other real, other real health conditions that are treated. And I think that's it. That's all I have for you today. Sorry, I went a little fast, but I wanted to make sure that we got everything covered in the shorter period of time today. This is a survey that you can take for today's session. And I think that's it. I think that's it. Awesome. Thank you so much, Stephanie. And thank you everyone for joining us. Our next session will be on August 30th. So keep an eye out for that. I'm sure that Gloria has that information if you still need it. And we will see you all then. I hope you all have a really great weekend. I'll make sure and share it with everyone. And it was really good. That was really good. So I appreciate it. And we can definitely do the September 20th for the one from last week. Okay, I'll go ahead and get that scheduled, Gloria. And then we should have the recording back, hopefully sometime next week. So I'll be able to get that out to you. Okay, great. I'll make sure and share it with everyone because these are some very important topics. Absolutely. Thank you. I hope you feel better too. Thank you. Thank you. Bye, everybody. Bye. Thank you.

stigma

substance use disorder

Indigenous communities

historical trauma

addiction treatment

education

holistic support