I am in recovery from an opioid use disorder. Most people in my life do not know this. I am hyperaware of how this knowledge could lead to scrutiny and a misperception of my character based on assumptions about addiction. The fear of being stigmatized has caused me to carefully navigate professional and personal interactions to mitigate the risk of being judged by the lowest point of my life.
Like a growing number of Hoosiers, I live every day aware of the stigma of addiction. I am sharing my story now because this is how stigma is broken. I hope this helps individuals suffering with an opioid or other substance use disorder find recovery, and that through dismantling the stigma around addiction in our community, Hoosiers with SUD will get the chance to find economic prosperity and personal fulfillment.
My path into addiction was not what many might think: I come from a relatively affluent background, I had loving parents, and I suffered no extraordinary trauma in my youth. I became a person with an OUD after earning my master’s degree. There was an economic recession, and the lack of job opportunities led me into a physically demanding job. I had an aggravated back injury and was given the option of spinal steroid injections or surgery. Rather than take these options, I started self-medicating with illicit opioids so that I could fulfill my professional responsibilities. What I didn’t realize was that I was also self-medicating for anxiety and depression.
Less than a year into my addiction I knew I had a problem, but stigma and shame stopped me from asking for help. I grew up believing that mental health treatments of any kind were signs of weakness, and I thought my own inadequacy was the reason I could not kick my habit out of sheer force of will.
Throughout my addiction, I lived in a perpetual cycle of opioid use, guilt and shame. I was afraid to ask for help from my family, certain they would judge or even disown me. I was afraid to seek help from a medical facility, fearing a mark on my record could prevent me from receiving medical treatment in the future. Every day I was determined to quit, but the longer I failed to seek help, the more my addiction progressed. I eventually became so isolated that I didn’t see a path forward to a productive life. I became extremely nihilistic, at times suicidal and apathetic about the future.
Anyone familiar with addiction has heard that a person with an OUD or SUD must reach rock-bottom to overcome an addiction. This was not true for me. There were many instances in my four years in active opioid addiction that could be considered rock-bottom. These moments only reinforced the anxieties that perpetuated my use. What led to my recovery was a combination of treatments and a chance at personal fulfillment.
After many failed attempts at sobriety, I became pregnant, started medication for opioid use disorder and enrolled in an intensive outpatient program based in cognitive behavioral therapy that happened to handle primarily child protective services cases. I was in group therapy with six other moms, most of whom were addicted to methamphetamine and were struggling to navigate a difficult path to recovery, along with the stress of having their children placed in foster care. A terrifying truth about the power of a substance use disorder is that the desire to maintain custody of your child is often not enough to prevent a setback, and many of these women were unsuccessful. Without the addition of medical assistance, family support and eventual gainful employment, I likely would not have maintained my sobriety into motherhood and would not be where I am today.
I am lucky that, because of the relatively low level of trauma I have suffered in my life, I am resilient to the aftermath of addiction and was able to end treatment successfully. Early in my recovery, I believed my resilience was due to personal strength, but I know now that I am not extraordinary. I am simply more privileged than most people who find themselves in my situation. I was lucky to find the resources I needed at a time when I wanted help and was motivated to get sober.
Many people, including many living in recovery, do not see medication assistance as a viable treatment option for SUD. Many with this belief don’t understand that overcoming the initial withdrawals of a substance is only the beginning. Post-acute withdrawals can last up to two years into recovery, and for some people, cravings can last a lifetime. The beginning stages of recovery are challenging because of the chemical alteration of neural pathways and the degradation of normal coping mechanisms that occur over years of self-medication. For many with an SUD, a major challenge of maintaining recovery is facing a lifetime of emotional trauma that their drug of choice had helped them to suppress. Exacerbated by the negative emotions associated with the stigma of being persons with an SUD, this emotional stress often leads to setbacks, and the rate is much higher for those not receiving medication-assisted treatment.
Overcoming stigma will take a collective act of societal empathy. Education about who persons with an SUD are and how addiction works is an important first step. I am excited by the work being done by the state of Indiana through Next Level Recovery and the Know the Facts campaign. Next Level Recovery is a data-driven approach to connecting Hoosiers to recovery services and reintegrating those in recovery into society. Know the Facts combats the stigma around addiction through education and the sharing of recovery stories.
In order to move past this drug epidemic, we must be willing to help those in recovery lead productive lives. We must remove barriers to employment and housing for those in recovery and enact a scientific approach to combatting addiction. Together we must work to overcome the stigma of addiction and not allow it to forestall solutions to this crisis.
Lisa Milton is assistant operations and property manager at an Indiana state park and holds leadership roles at environmental nonprofits.