Stigma only makes drug use more deadly

When people who use illegal drugs feel like they have to hide their use, the risk of overdose soars.

- STEPHEN P. MURRAY

SCOTT OLSON Getty Images A VENDING MACHINE in Illinois with naloxone, offered free so a bystander could administer to someone overdosing on an opioid.

UNTIL WE STOP framing all drug use and every overdose as problems of "addiction" and "substance use disor ders," we'll keep missing the mark on overdose prevention. Historically, overdose was seen as a severe indicator of addiction - but that was never the best way to understand it, given that someone early in their use is potentially at higher risk than someone who uses chronically and has developed a tolerance. The drug supply's unpredictability has further weakened the link between overdose and chronic use, because anyonea decades-long habitual user or a first-time dabbler - can overdose on drugs that are more potent than expected or that contain substances such as fentanyl.

I used opioids, benzodiazepines and amphetamines for almost four years before my family noticed. In that time, I got through 102 credits of college and was elected to the local village council. Most of my drug use was helpful; it made me work harder, helped me cope with depression, and made me a more social, less anxious person.

Most people who use drugs don't see themselves as "addicts" or meet criteria for a diagnosis of addiction. Most drug use doesn't end in addiction, and many discontinue on their own without treatment. They're not all "suffering" and waiting to be saved. People use drugs for logical reasons: to ease their pain, to feel happy, to be less anxious and to escape. If they weren't serving a purpose, most people wouldn't start using them.