Featured Origami Elephants

The “Other Side” of Addiction

Posting pictures of overdosed addicts to the internet is NOT helpful intervention.

Checking in with my newsfeed yesterday morning, I was immediately confronted by pictures of two adults, overdosed and unconscious, in the front of their car with a four year old boy strapped into the seat behind them. When they recover, they will face a number of criminal charges for endangering the boy. However, the City of East Liverpool, Ohio along with the local police department, took it upon themselves to release pictures of the incident on Facebook in order to illustrate “the other side of this horrible drug” and hopefully convince another user to think twice” before engaging in further use.* Not only do I believe that they were wrong to post these pics, but I further believe that their decision to do so points to prejudices that constitute the real “other side” of drug addiction. In turn, these prejudices need to be overcome if we ever hope to be effective in beating the opioid epidemic.

To begin with, the adults in the Ohio photos were unconscious at the time the photos were taken. And being unconscious means being unable to give consent. Generally, consent plays a big role in our day to day lives. Whether we are visiting the doctor’s office, upgrading computer software or signing off on a school field trip, we are constantly being asked to indicate that we agree to certain terms. So the instances in which consent is slighted should clue us in to a deeper disregard. For example, it seems we are still having to make the case that consent is an essential part of sexual relations. And, if the Brock Turner sexual assault case is any indication, the lack of consent implicit in incapacitation is not universally acknowledged and protected. Taken against how regularly we give consent in other situations, these omissions reveal an embedded societal stigma around particular classes of behavior such as sexual relations, sexual violence (which are two separate things), alcohol consumption and yes, illegal drug use.

Are we comfortable with the internet pillory?
Are we comfortable with the internet pillory?

The fact that the Ohio pictures depict illegal drug use and were taken during a police response does not substantially mitigate the violation of privacy committed in posting the photos online. And it seems that both the courts and police departments are beginning to agree. Due to the staying power of social media, posting pictures of suspects to Facebook has been ruled illegal in the past. The same concern is echoed in the comments of Police Chief Trevor Whipple of South Burlington, VT in a NYTimes article about his department’s decision to end posting booking photos to Facebook: “Posting on the Internet is kind of like a bell you can’t unring.”  While we have banned the pillory from the public square, the internet is being put to the same use and with longer effect. No amount of “bad” behavior, legal or illegal, should condemn someone to public (and potentially perpetual) humiliation. When we are willing to accept otherwise, we should be warned to beware.

This extends to instances in which our stated purpose in public punishment is education or prevention. In the famous “trolley dilemma,” when considering what actions are ethically acceptable to stop an oncoming train from hurting several people on the tracks, it is generally considered unacceptable to stop the train by pushing another person in its path. Likewise, Immanuel Kant prohibits treating another person as a means to an end in his ethical formulations. Whether it’s increasing the severity of a sentence to make a statement to others contemplating the same crime or posting a humiliating picture to influence another person’s behavior, it is an injustice to reduce a person to the unfortunate means by which a happier end is written for another person. 

Add to this, we know that it just doesn’t work. Study after study has disproven the “scared straight” model of intervention. People don’t change their behavior after being informed of the worst case scenario. Usually, people assume that they will always end up the exception rather than the rule. In other cases, we run the risk of normalizing or desensitizing the target audience to the very behavior we are hoping to curtail. In the end, posting pictures of people in desperate states isn’t documenting, it’s dehumanizing. Pictures like those out of Ohio are not going to shock anyone into anything beyond reenforcing their disgust and condemnation.

And disgust and condemnation continue to dominate our perceptions of drug addicts and addiction. Somewhere at the base of our brains we believe that the people involved in cases like that in Ohio have morally disqualified themselves from normal considerations as outlined above. To put it flatly, we believe they deserve “it.” “It” being a stand in for any consequence perceived by the court of common opinion to be associated with the incident. Along these lines, as long as we continue to believe that addiction is a moral failing, we will continue to fail to address the medical realities of drug addiction. And as a result, we will continue to fail drug addicts and their families.

For example, one of the biggest practical indications that we view addiction as a moral rather than medical problem is the continued reliance on 12 step programs for treatment. In general, these programs are based on several principles including that, with the help of community and the strength of a higher power, an addict can effectively adopt a new set of behaviors. Meanwhile, 12 step programs report only a 5% to 10% success rate in preventing relapses of addiction. Further, many 12 step programs not only don’t include medical intervention for chemical dependency, but actively condemn it despite research demonstrating its effectiveness. I would also argue that the general unawareness that there is a distinct difference between drug addiction and chemical dependence is further evidence of prejudice. Predictably, training for doctors in addiction remains underfunded and largely unavailable. Although signs of change are visible, they are slow to emerge given the shame and judgement surrounding addiction.**

If you want to see the “other side” of drug addiction, then look into the faces of the friends and family members who have worn themselves out working to find effective treatment for their loved ones, all the while worrying that help won’t come in time. It’s time to stop reposing pictures, cease the scare tactics and move beyond medieval measures of public shaming. We cannot turn back the opioid epidemic until we are willing to look inward and confront the prejudices that are condemning people to humiliation rather than advocating for their recovery.

*These quotes and the pictures in question can be found on the city’s Facebook page. I am not linking to the page on purpose.
**Radiolab’s podcast “The Fix” highlights some of these changes. It’s a great show for anyone interested in more information.