‘from Shame And Blame To Support And Healing’: Nc Launches Campaign To Reduce Stigma Around Substance Use

By Rachel Crumpler

Two years ago, Tyler Yates mislaid his champion friend to an overdose. At nan urging of different personification successful nan betterment community, Yates said his champion friend stopped taking buprenorphine — a medicine utilized to dainty opioid usage upset that helps trim supplier cravings. 

About 2 weeks later, his friend returned to usage and died. 

Despite investigation showing that medications for opioid usage upset are highly effective, their usage tin often beryllium met pinch judgement because group see them “substituting 1 supplier for another” and deficiency knowing of really they thief successful recovery.

“That’s a communicative that we perceive excessively often,” said Yates, organization overdose prevention initiatives coordinator astatine nan authorities Department of Health and Human Services. “There is nary logic for this medicine to beryllium stigmatized.” 

This is conscionable 1 illustration of nan stigma astir constituent usage that group pinch constituent usage disorders shared astatine nan quarterly gathering of nan Wake County Drug Overdose Prevention Coalition.

Another attendee shared really a nurse’s look wholly changed aft nan caregiver noticed way marks connected her limb while taking her humor pressure. The female said it made her consciousness “dirty” and near specified a antagonistic belief that she said she hasn’t been backmost to that infirmary successful nan 7 years since. Other attendees shared really harmful labels, specified arsenic “addict” and “junkie” person lowered their self-esteem.

People pinch histories of constituent use, advocates and wellness officials each opportunity that stigma is simply a superior obstruction keeping group from getting treatment.

That’s why authorities leaders launched Unshame NC, a statewide run aimed astatine ending stigma related to constituent usage disorder. The campaign, announced astatine nan July 21 gathering successful Raleigh, has 2 superior goals: to dispersed knowledge and consciousness of constituent usage upset and to amended group astir medications for opioid usage upset arsenic a curen option. 

To execute this, nan run will item North Carolinians sharing their individual experiences pinch constituent usage upset and betterment to thief “open minds and alteration hearts.”

Kelly Crosbie, head of nan state’s Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services, and First Lady Anna Stein denote Unshame NC, a run to extremity stigma astir constituent usage connected July 21 astatine nan Wake County Drug Overdose Prevention Coalition meeting. Credit: Rachel Crumpler / NC Health News

‘Shift nan narrative’

“Substance misuse is super, ace common, but feelings of shame and embarrassment are keeping group from reaching out,” said Kelly Crosbie, head of nan state’s Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services. 

“What you extremity up pinch is group who scope out, really successful times of desperation,” Crosbie said. “We don’t want to beryllium getting to group erstwhile they overdose. We’ve sewage to make group beryllium okay talking astir intelligence wellness and constituent misuse early and often, and if they do request help, not consciousness ashamed to spell get it.”

Unshame NC, which has been successful nan useful for astir 2 years successful business pinch nan nationalist nonprofit Shatterproof, is championed by authorities first woman Anna Stein. Reducing stigma faced by group pinch constituent usage disorders is 1 of 3 privilege issues Stein has for nan clip her hubby is successful office. 

“I’ve seen firsthand really detrimental stigma is connected truthful galore levels — arsenic a artifact to meaningful argumentation change, arsenic a wedge betwixt group who usage narcotics and those who don’t,” said Stein, who served arsenic an lawyer and argumentation advisor connected nan authorities wellness department’s supplier overdose prevention team.

“People surviving pinch a constituent usage upset are basal threads successful nan cloth of our communities,” Stein said. “They are our neighbors, coworkers, friends and family members… It’s captious that we displacement nan communicative from shame and blasted to support and healing.”

View nan Unshame NC website

Perceptions of constituent use

An estimated 1.4 cardinal group successful North Carolina — astir 1 successful each six adults — has a constituent usage disorder, according to DHHS. 

Over nan past 2 decades, much than 41,000 North Carolinians person died from supplier overdoses, according to authorities wellness section data. In 2023 — nan twelvemonth pinch nan highest number of overdose deaths connected grounds — nan section estimated that an mean of 12 group died from an overdose each time successful North Carolina. 

While 2024 information is not yet final, an estimated 3,213 North Carolinians are suspected to person died from an overdose — a projected 28 percent diminution from nan twelvemonth before.

North Carolina information showing overdose deaths complete nan past decade. Credit: N.C. Department of Health and Human Services

Crosbie said constituent usage disorders are chronic, treatable aesculapian conditions. However, she said, galore group still spot constituent misuse arsenic a civilized failing. A May 2025 statewide study recovered that only 1 successful 5 adults successful North Carolina recognizes that opioid usage upset is simply a aesculapian condition, she said.

“Viewing constituent usage arsenic a civilized rumor doesn’t thief america get to a amended place,” Stein said. “There are group who don’t usage substances that are full jerks and group that usage substances that are conscionable lovely, benignant people. Taking morality retired of it and viewing [substance use] arsenic benignant of this holistic wellness rumor and helping group lead nan lives they want to unrecorded would beryllium a useful perspective.”

The aforesaid study recovered that 57 percent of North Carolinians cognize personification pinch opioid usage disorder. Despite this prevalence, only 34 percent of North Carolina residents opportunity they cognize really to find value curen for themselves aliases their loved ones. 

And 35 percent of group said abstinence is nan only acceptable shape of treatment.

These numbers supply a model into nan beliefs and attitudes that nan Unshame NC run will beryllium moving to change.

“The information is conscionable genuinely astonishing,” Crosbie said. “That’s why [this campaign] is truthful important.” 

She said nan state’s efforts to supply and grow support for group pinch constituent usage disorders tin only spell truthful acold if stigma is holding group backmost from seeking and receiving treatment. 

Spreading champion practices

For group who want to extremity utilizing opioids, location is nary one-size-fits-all approach. However, authorities wellness officials are focused connected making judge much group cognize astir and person a measurement to entree 1 effective option: medications for opioid usage disorder.

Treatment for opioid usage upset that includes 1 of 3 U.S. Food and Drug Administration-approved medications (buprenorphine, methadone and naltrexone) — paired pinch counseling — is considered best practice. 

Methadone and buprenorphine stimulate nan aforesaid parts of nan encephalon arsenic commonly abused drugs, which tin dampen cravings that group person for nan narcotics while not producing nan aforesaid “high.” Methadone and buprenorphine person been wide studied and shown to greatly reduce nan consequence of overdose death. 

Naltrexone — often fixed arsenic a monthly injection — useful otherwise by blocking nan body’s expertise to get precocious from opioids, but location isn’t arsenic overmuch information to support its efficacy.

Only a fraction of people pinch opioid usage upset — successful North Carolina and crossed nan United States — person these medications. Nationwide astir 1 successful 5 group pinch opioid usage upset was taking 1 of these medications successful 2021, according to nan National Institute connected Drug Abuse. 

One obstruction stymieing these medications’ usage is that galore residential curen options successful North Carolina prohibit nan usage of medications for opioid usage disorder, requiring abstinence only. A 2024 study led by NC State University interrogator Jennifer Carroll surveyed nan state’s 94 residential curen providers and recovered that among nan 66 who responded, unit from half of nan providers made negative, discouraging aliases stigmatizing remarks astir medications for opioid usage disorder.

“They see it everything from a crutch to you perceive nan aged adage ‘substituting 1 supplier for another,’” Crosbie said. “That is conscionable inaccurate.”

Crosbie said taking medications for opioid usage upset should beryllium thought of for illustration immoderate different medicine prescribed to personification for a wellness condition, specified arsenic slump aliases diabetes.

“[The medications] really thief them consciousness amended and trim cravings and bad broadside effects, and there’s nary shame successful that,” Crosbie explained. “It’s for illustration saying there’s shame successful taking Tylenol, which doesn’t make immoderate consciousness to maine astatine all.”

While individual physicians tin prescribe buprenorphine and naltrexone from their offices, nan state’s Opioid Treatment Programs are nan only places wherever a prime from each 3 FDA-approved medications are available. These Opioid Treatment Programs are authorities and federally licensed to supply nan medications and different supports for curen and recovery, including counseling, lawsuit guidance and adjacent support services.

North Carolina has 94 programs dispersed crossed 53 counties that served 31,641 patients successful 2024, according to DHHS information shared pinch NC Health News. Currently, 24,712 group from each 100 counties are enrolled astatine 1 of nan state’s Opioid Treatment Programs. A DHHS spokesperson said these clinics are connected way to transcend 2024 diligent volumes this year.

North Carolina’s first mobile Opioid Treatment Program, which dispenses medications for opioid usage disorder. The mobile portion is operated by Morse Clinics and launched successful July 2025 successful Wake County. It presently is stationed extracurricular Healing Transitions’ men’s campus. Credit: Courtesy of Eric Morse

Crosbie said authorities wellness officials are moving to help medications for opioid usage upset scope much people. One caller attack includes nan motorboat of nan state’s first mobile Opioid Treatment Program successful Wake County. Operated by Morse Clinics, it sewage up and moving a fewer weeks ago. 

“We dream to get mobile clinics to each nan corners of nan authorities that don’t person treatment,” Crosbie said. 

Crosbie said she’s besides moving to make medications for opioid usage upset accessible astatine organization wellness centers.

‘A existent opportunity’ 

The timing of nan Unshame NC run aligns pinch nan infusion of opioid colony costs — astir which authorities and region leaders will person to make captious spending decisions. North Carolina is group to person complete $1.5 billion, distributed complete 18 years.

That makes now a peculiarly valuable clip to combat stigma and raise greater consciousness of evidence-based betterment practices, Crosbie said.

“We dream to alteration attitudes first and foremost,” Crosbie said. “If we tin alteration attitudes complete this twelvemonth and nan adjacent year, we will beryllium capable to power argumentation and backing decisions.”

The run is aimed astatine nan wide public, but it besides seeks to scope section and authorities leaders and members of nan betterment community, she said.

Wake County leaders opportunity they already grasp nan value of reducing stigma.

“We person a existent opportunity to make an finance to extremity stigma,” said Alyssa Kitlas, Wake County’s opioid colony programme manager. “Stigma keeps group we emotion from getting help, from talking astir nan challenges they’re going through, and honestly, puts group astatine consequence of dying.”

Explore really section governments are spending opioid colony costs connected nan state’s dashboard

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