If you live in America, you have likely lost members of your high school class to what’s commonly known as opioid addiction. They have become victims, now, of America’s opioid crisis.
In 2017, the last year we have data for, the National Institute of Health’s Institute of Drug Abuse counted a staggering 47,600 Americans killed by opioid use — compared to 8,048 in 1999: 130 people a day. We have no reason to think that, with the current rate of opioid use, this number will not continue to rise, as it has every year.
Those living with what the American Medical Association calls “opioid-use disorder” (OUD) are deeply stigmatized by the rest of society. You think you know what they look like. You probably think of a teenager stealing their mother’s pain pills. You might think of a guy scratching himself outside the gas station. You could think of skinny bodies, gray skin, ratty and unkempt. You might think of words like junkie, addict, stoner, crackhead.
But chances are, you do not think of Christopher Charles Gaunce or anyone like him.
Christopher, his uncle Daniel Elijah Sanderfer tells Scary Mommy, died on May 11, another victim of America’s opioid crisis at only 31 years old. In his obituary, his family says he “died unexpectedly.” When the opioid use took over, when he began to lose everything to it, he stared at his uncles, Daniel and Will. “I’m still the same boy I was,” he pled.
For the long course of his addiction, you never would have pegged Christopher as someone who used opioids. He was fit, making a living working manual labor. Christopher stood tall, muscular and handsome, like a high-school football star. You wouldn’t have known he struggled with OUD. You wouldn’t have pointed to him and said: there. He uses. He always believed hard work would save him. But it only took one bender, one bad pop. He hadn’t planned to die. He had come to work in the morning.
But no one talks of his OUD, his uncle tells Scary Mommy. This is the stigma we attach to opioid use.
The stigma of OUD is so bad, in fact, that WRVO reports that a man in Syracuse, New York — trained in the use of Narcan, a life-saving substance that reverses the effect of opioids, and who trained 500 other people — died of an overdose himself. The executive director of his center says that, “A couple people may have known Donovan was occasionally using again, but he … never asked for help the way he should have … This is a typical overdose. We’ve had many of them. People end up using alone, and they die alone … The stigma is so bad.”
Tricia Stouch has to lead off the story about her daughter Pamela’s struggle with OUD, according to WPSU, by telling people what an involved mom she was, how she coached softball and went on school trips. She has to say that Pamela “was a really hard worker, taking college classes and holding down a job.” Stouch travels through Pennsylvania, speaking to groups to try to erase the stigma those like her daughter face in the fight against OUD.
According to the American Medical Association, opioid addiction is “overshadowed by its misconception as a moral weakness or a willful choice.” In other words, we think people still have a choice. The National Academies of Science, Engineering, and Mathematics says that over 2 million Americans live with OUD, which is “a treatable chronic brain disease resulting from changes in neural structure and function that are caused over time by repeated use of prescription opioids, heroin, or other illicit opioids.”
But there are major barriers to treatment, mainly caused by stigma and the criminal justice system, which often forces treatment, such as methadone, to be discontinued. A spotlight by the Surgeon General says that only one in four people with OUD received treatment in the past year, and that may be optimistic — the AMA claims only 2 in 10 have access. Many have a co-morbid psychiatric disorder; very few receive treatment for both.
This what stigma does. When doctors use words like “clean” and “dirty” to describe the results of urine tests, they enforce that stigma. One man, in an issue of the American Psychological Association, details the stigma he’s faced in finding housing, academic funding, and access to education — and he’s in recovery. The more stigmatized people feel, the less likely they are to seek treatment. The less likely they are to seek treatment, the more likely they are to overdose.
You think junkie. You think addict. You think moral failing, you think choice.
You do not think brain chemistry, a complex interaction between genetic and neural pathways and the lack of choice, the reduction to sheer need. You do not think: this person has reached the end, and they have a physiological and psychological addiction they cannot break without help. They need help, medical help, in order to recover from the disease they face alone. They need the support and love of their families. They are still the same boy.
Christopher Gaunce loved movies, his uncle tells Scary Mommy. From the time he was a little boy, he’d see his Uncle Will and ask, “When are you gonna take me to see a movie?” At the end of Christopher’s life, his uncle was dealing with many health problems and couldn’t go out.
“We never got to go see another movie,” his Uncle Will said.
This is the true face of OUD: not the guy outside the gas station. Not the skinny person you imagine. OUD is the unanswered question, hanging forever in the air: When are you gonna to take me to see another movie?
It’s society’s stigma that leaves it echoing.