The Words We Use Matter
Episode Guest:
Courtney McKeon
In the second episode of Season 2 of The Mayo Lab podcast, Courtney McKeon, the vice president of the National Stigma Initiative at Shatterproof joined co-hosts Meagen Rosenthal, Ph.D, and Alexis Lee as they dissected how the language around addiction can unintentionally feed stigma.
McKeon explained how terms like “addict” can act as a barrier for empathy and personhood. By reframing how one speaks about issues like these and centering the person affected—such as “a person with a substance use disorder” instead of “an addict”—we can combat substance use stigma.
“That is what we see from the data that people with this disease, they don’t feel worthy of recovery. They don't feel worthy of living because their support systems aren’t always so strong. They’re not educated that, ‘This is not a choice. This is not something I just decided one day that I was going to have this condition.’”
— Courtney McKeon
Not only do these stigmas impact our community and the way people view substance use disorders, they can affect those dealing with substance use issues personally. McKeon shared information from a comprehensive survey Shatterproof released in 2021 that showed the pervasiveness of stigmas surrounding substance use disorders. The survey showed that 75.2% of respondents do not associate addiction as a chronic medical issue, similar to arthritis, diabetes or heart disease, and 55.6% of respondents were unwilling to spend an evening socializing with a person with a substance use disorder.
“To think about how people feel stigma when they’re in active use and then how they continue to feel it while they’re in recovery, it can be a barrier to sustained recovery,” McKeon said.
McKeon went on to say that Shatterproof found that there lies a disconnect between what structural policies many people support and what they’re willing to see in action. “While we almost always see tons of support for structural policies, such as we found 87% of respondents believe that people who are addicted to drugs should receive treatment instead of being sentenced to prison,” said McKeon, “but in that same breath, same respondent pool, we also saw that only a little over 50% would be willing to have a clinic that provided medication for opioid use disorder in their neighborhood.”
How can we help people understand these stigmas in a way that is gentle and helpful? At Shatterproof, they’re collecting stories. “Dozens and dozens of stories,” said McKeon, “and that's different than any regular communications campaign because a lot of communications campaigns will only invest in 1, 2, 3 stories and have almost like a poster individual for a campaign. We want to show substance use disorder shows up everywhere…So putting a face and showing people that they can work with you, they can live next door to you, they can lead productive lives.”
She added, “These people are the same exact people, whether in active use or in recovery. Really understanding that it’s a medical condition and they can live productive and prosperous lives in recovery.”
Showing these stories and asking questions about stigma has led to a 10% reduction of public stigma for those who were exposed to their campaign in just one year.
“What we do in this space matters, and it matters in a measurable way. And I think that is my plea to our listeners that this stuff does matter. It matters how we talk about it. It matters how we engage with people. It matters how we think about it,” said Rosenthal.
To hear more from Episode 2 of Season 2, scroll down to listen to the episode or read the transcript.
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Meagen Rosenthal:
I am Meagen Rosenthal.
Alexis Lee:
And I'm Alexis Lee, and this is The Mayo Lab Podcast.
Well, hello everyone and welcome back to The Mayo Lab Podcast and our first episode diving into specific topics within stigma. I know Meagen and I are very excited for this episode and all the episodes to come, but this one felt really special. And we get to have a chat with not only someone who's doing work in this space, but someone we get to work with in this space, which I think makes it extra special.
Meagen Rosenthal:
That's right. We are very excited to have Courtney McKeon here today with us, and she's going to talk a little bit more about stigma related to addiction and substance misuse. And I'm not going to do you any disservice, Courtney, by talking about you in front of you, but we're going to ask you to introduce yourself to us and our audience and then we can start the conversation from there.
Courtney McKeon:
Perfect. Thank you both so much for having me. I am very excited about this opportunity, especially because we are about to dive into some work together. So thank you again for having me today. My name is Courtney McKeon. I am the vice President of the National Stigma Initiative over at Shatterproof. Shatterproof is a national nonprofit working to reverse the addiction crisis. We have three pillars of work, and those pillars of work include transforming the treatment system, supporting and empowering communities, and then that third pillar is what we are focused on today, which is ending the stigma of addiction.
Alexis Lee:
I'm so excited. I'm so excited to have this conversation. And in your words, Courtney, and in your background and your research, we kind of want to focus on two different words, if you will, or two different places. And so start with the first one of addiction. Can you explain the definition of that and an overview what it is in its actual terminology?
Courtney McKeon:
Yeah, of course, Alexis, so just like you have both already hinted to, addiction is not unique to substance use. People can develop an addiction to any habit-forming activity. So for the purposes of this podcast, we'll talk about substance use disorder. We may also see that throughout this podcast we tend to use substance use disorder and addiction interchangeably because the general public are more familiar with the term addiction. So it's definitely something, they're very different, but we will see that we'll use them interchangeably.
So substance use disorder actually exists on a spectrum and symptoms can range from moderate to severe, and addiction is the most severe form of substance use disorder. So addiction we like to say is a treatable medical condition involving complex interactions among genetics, the environment and individual's life experiences. Addiction is not a result of an individual's moral failing or a character flaw. Substance use often begins as a response to someone's environment or as solution to mental challenges or emotional challenges. Substance use can then develop into addiction as a result of these complex interactions. So that's how I would define addiction.
Meagen Rosenthal:
I love that.
Alexis Lee:
And then I mean, it's just so yes. There's so much there. Another word I want to get into to get your definition, but also to change the verbiage a little bit here for our audience and listener, and that is the word addict. Can you go into that, explain that and then also explain why maybe that's not the best word to use for this situation?
Courtney McKeon:
Yeah, for sure. And we hear this word a lot, especially in media and pop culture. Addict is a term often used to describe someone with a substance use disorder regardless of the severity of their medical condition. So as you hinted to, we do not recommend that people use the term addict. There's evidence that it increases stigma. And we also know that stigma is a major barrier to people receiving treatment for their substance use disorder. I feel as though when people use the term addict, they are holding someone's medical condition against them and they're defining them solely by that medical condition. Rather, we recommend that people use person-first language. An example of this, instead of using the term addict, would be, "A person with a substance use disorder." Or, "Courtney with a substance use disorder." By putting someone's personhood first, they're no longer defined solely by their addiction.
Furthermore, there's lots of studies in this field that talk about the impact of stigmatizing language. So for example, there was a study in 2010, it was conducted with more than 500 trained mental health and addiction clinicians to understand whether referring to someone as a substance abuser rather than an individual with a substance use disorder would lead to different treatment behaviors. The study found that respondents exposed the term, "An individual with substance use disorder" were less likely to say the person was personally responsible for their illness and were less likely to recommend punitive rather than therapeutic action. So there's just an example where the research really reaffirms the impact that stigma and language can have on someone's health outcomes around substance use disorder.
Meagen Rosenthal:
I think that's a really important observation to make because oftentimes we're thinking about the treatments related to substance use disorder and the stigmas attached to that, that we have this instance when we're blaming the individual for something that they really don't have any control over. And I'd be curious to know if you could dive into any of the other research that you talked about in terms of the impact of stigmatizing language on the individual who is suffering with substance use disorder. What impact does that have based on what you've seen and what you all have experienced in that space?
Courtney McKeon:
Yeah, so I definitely have pulled out some of these, you tell me, Meagen, should I jump into some of the other facts that I was-
Meagen Rosenthal:
Please do, yes.
Courtney McKeon:
Perfect. Okay. So as we talk about, I would say, the self-stigma that a person feels from the words that we use in particularly. So Shatterproof put out the Shatterproof Addiction Stigma Index back in 2021. It was a first of its kind tool and most expansive survey ever put out to really understand the stigma around substance use disorder and people who use substances. This survey starts with a vignette. So it's a story about a person named John and using the DSM-5 describes John as having a substance use disorder or an opioid use disorder without ever using those terms, kind of in a way to level set with the respondents so that everyone's picturing the same exact thing. There's really, I don't know what the word I'm looking for is, but bothersome stats. It definitely reaffirmed a lot of the things that we already knew. But it was concerning and it shows that there's a lot of work that needs to be done in this area.
So just to highlight some of that, 75.2% of the public did not believe that a person with substance use disorder was experiencing a chronicle medical illness such as diabetes, arthritis, or heart disease. So to your point, 53.2% of respondents held the belief that substance use disorder was caused by a person's bad character. So then as we look at our social distancing questions, which are a proxy for how people behave or discriminate against those who have substance use disorder, 55.6% of respondents were unwilling to spend an evening socializing with a person with substance use disorder. And stigma still persisted if a person was deemed being in recovery, which was haven't using a substance for more than a year, with 30.5% of respondents still being unwilling to spend an evening socializing with someone who was in recovery from substance use disorder.
That stigma is further internalized by the person. And then as we think about self-stigma, we know that people who are in recovery from a substance use disorder, over 30% of them still feel ashamed of themselves. And we know that it's one thing to be a barrier to someone entering recovery, we also know that recovery is not a straight line, just like any medical condition. So to think about how people feel stigma when they're in active use and then how they continue to feel it while they're in recovery, it can be a barrier to sustained recovery. So I know that was a long-winded answer, but I was really excited to share some of Shatterproof's primary research and how that has really informed the way that we look at our work and the approaches we're taking to try to reduce stigma.
Meagen Rosenthal:
Yeah, no, thank you so much for that. And there's a lot to unpack there. So I'm going to go back for a second. So the first thing that you talked about, and forgive me because I'm totally going to get the numbers wrong, but the first thing you talked about was 75.2%, I think it was, of people who completed the survey didn't make the connection between addiction being similar to in terms of a disease as a diabetes or a hypertension or a what have you. I think that's just fascinating for us to understand. And then you think about the history of these conditions over time, addiction has always existed in our world. This is not a new thing. How we talk about it though has certainly changed. And I think about in my own lifetime, and maybe this relates a little bit to the struggle that we're having as a society and understanding that shift in how we understand what addiction is.
So once upon a time, people did consider it to be a moral failing because we didn't understand all the nuances of how the brain works and what the impact of that is on our body and all of those different kinds of things. And now we're shifting that language. And because human beings are averse to change, that's a thing that we all struggle with, we haven't quite caught up to the importance of that language shift and that understanding shift. So that's a huge number of people. And then you couple that with this idea that if you're engaging with or maybe potentially engaging with somebody who has an addiction or is in recovery, then you're less likely to embrace them and have them be part of your daily life or spending an evening with them. And then just compounding that over time.
And I think about the impact not only that has on the individual who's suffering with an addiction, but then also in the family of that individual. Because oftentimes, eventually the secret is out and people know. So suddenly you're compounding that stigma not only with that individual person, but also within that family unit and the larger community. And I think the thing that's most interesting to me about this is that if you think about it in relation to all of the work that Alexis and I have done so far, and I'm sure all the work you all have done at Shatterproof, it's not a unique event to have to have happen. It never ceases to amaze me that if it's not somebody in your family, it's somebody adjacent to your family. It's a friend of your own, it's a friend of your family, it's multiple friends and multiple families.
And so I think about the weight of feeling that burden and the shame and the secrets that need to be kept because, "Gosh, I don't want anybody to know that about me." And how much extra weight that adds to this process. It's incredibly hard to go through already at baseline, right? You're fighting brain chemistry. Then you're fighting social pressure too. One of the reasons it's so important for us to be having this conversation here today is to understand and to think about that and get it out in the open. I think about, and you talked a little bit about this already, some of the common stigmas, this idea of that self stigmatization.
But what are some of the other examples that folks can draw from? What does stigma look like in practice? So it's not wanting to meet them for dinner. What are some of the other hints that folks might not even realize are stigmatizing behaviors. Person-first language, not wanting to have dinner with them that results in that self-stigmatization? What are other things that we need to be on the lookout for in our day-to-day lives as we're interacting with everyone around us, but in particular those who might be suffering with an addiction?
Courtney McKeon:
Thank you for everything that you just underscored. Again, that's why, like you said, this is such an important conversation to be having. I want to circle back for one more second around language, because I think an important piece that we didn't cover is that people who have substance use disorders use the term addict to self-identify. And that's okay. We should support anyone's right to describe themselves however they see fit. But it's important for us in the general public who do not identify as having a substance use disorder to not mirror that language and to use person-first language because of everything we know that the research says around language. So for example, my mom is about to celebrate 11 years in recovery and having conversations with her around this, it's very fascinating. She calls herself an addict. She doesn't see the harm in calling herself that, and that is fine. That was her story and her journey, and she should be able to talk about it with any terminology that she would like.
So I always emphasize when I'm having conversations with her to ensure that I am saying, "My mom has a substance use disorder, or my mom is in recovery. Or at one point she had a recurrence of substance use." Not saying that she relapsed. So I'm very particular and intentional about the words that I use when describing my mom's story, but she might use a lot of words that we deem stigmatizing in her everyday language. So that's one point I want to... Because for example, the media uses these terms so much, they kind of just get embedded into our everyday life, into our language. And yes, the media is very influential in how we see the disease of addiction, and we understand and put a face to what it looks like. It's important to just make that call out, that just because some people use that term doesn't mean that everyone should be using that term.
The other thing that you mentioned is that this is just not unique. Substance use disorder impacts everybody. And I think as you talked about how language has changed and how the understanding of substance use disorder has changed over the years, what I think about is the war on drugs and how people, you want to talk about seeing substance use disorder or addiction as a moral failing or a personal choice, thinking about how at that time, how disproportionately people of color were stigmatized in a way for having addiction. But when we looked at Caucasian, more wealthy communities and families, it was seen as a status of wealth.
So thinking about how that has changed over the years, and I think that is why... One of the things that Shatterproof does is we use a contact based strategy when we try to reduce the stigma of addiction, what that looks like is showing people that a person with a stigmatized condition such as substance use disorder can look just like a person who has stigmatizing views. So we do that through story sharing. Let's not make this a secret. Let's share with people people's journey to recovery, what stigma looks like. And sometimes people will say, "I didn't experience stigma." And then they'll tell their story. And it gets to what you're saying. It's like, are we even realizing what stigma can look like and how it shows up in our everyday life?
One of the things personally, my dad passed away when I was 12 years old from complications from a substance use disorder. He actually was infected with HIV from intravenous drug use. And to think about the compounded stigma that my family felt around my dad being HIV positive, then also struggling with a substance use disorder. I was young, so no one told me what was going on. But when I saw it play out after when he was passing away, and my family decided to have a private funeral, they didn't want to talk about how my dad died. They didn't want to invite others in to even say bye to him.
And I know in retrospect that all too often stigma is actually what's killing people. It's not necessarily the substance use disorder itself. My dad didn't feel worthy. And that is what we see from the data that people with this disease, they don't feel worthy of recovery. They don't feel worthy of living because their support systems aren't always so strong. They're not educated on that, "This is not a choice. This is not something I just decided one day that I was going to have this condition."
I think I kind of got off on a tangent, but it manifests. And I think the word, what we have learned too through our work is that stigma, the reading level of stigma is quite high. People don't even know what stigma means, especially as you look at other cultures. We just did some focus groups around language and we worked with the priority populations. And one of our priority populations, because we're doing work in California, was really understanding how Spanish speakers understood these words. And when the focus group data came back, they actually didn't understand what prejudice, stereotypes or stigma meant.
So to think about how do we even talk about this issue and how it comes to life on a day-to-day when people don't even know what stigma is. So I think the thing that people understand more is discrimination and that's the active behavior of going against somebody with a condition such as substance use disorder. So I think the things that we can think of too, is just what we have seen a lot in our work, is people are always super supportive of structural policies around substance use disorder. So for example, I want to say in one of our states when we did our survey, we do a Shatterproof Addiction Stigma Index in every state before we start so that we can really understand what the landscape looks like tailored to that state. What are the specifics in that state based on rural, suburban, race, ethnicity, age? How does stigma show up and where are people having more stigma in some areas than others?
While we almost always see tons of support for structural policies, such as we found 87% of respondents believe that people who are addicted to drugs should receive treatment instead of being sentenced to prison. But in that same breath, same respondent pool, we also saw that only a little over 50% would be willing to have a clinic that provided medication for opioid use disorder on their neighborhood. So then we see that we call it not in my backyard or that NIMBY attitude, right? And I think that is a place where people sometimes will actively be like, "No, I understand. Because I supported that policy or whatever." But the truth is that doesn't actually translate into everyday behaviors and attitudes. And so again, long-winded answer, I just am thinking broadly about everything I thought about to come to the table for the podcast, and-
Meagen Rosenthal:
I love it. I think you're totally on the right... Well, see now because this is how we're having a good conversation here, because this made me think about something else.
Voiceover:
You are listening to The Mayo Lab Podcast. For more information and resources, visit themayolab.com. Now, back to the episode.
Meagen Rosenthal:
So we had talked about a minute ago this idea that stigma has been in existence for a long time, and we struggle with the reappreciation of where we stand with it now. Is it being a disease? Et cetera, et cetera. Then you talk about this really just brilliant actualization of how these things disconnect from each other, right? So we're talking about, "Yeah, sure. Of course. If you have an addiction, you should absolutely get treatment. I would not stand in the way of that. Unless it's in my backyard." And then those old added ideas of like, "Well, who are the people who have an addiction? I don't want those people near to me and my family." And then it all falls apart.
I also build on top of that, this idea that you just talked about with some of the other research that you all had done with the Spanish-speaking population in California. I would hazard a guess that you would find not dissimilar data in all populations across the United States when you're thinking about what does stigma actually mean and what do those terms look like? Because that language is embedded in our everyday speak. We just internalize it in a way that we don't really have a great appreciation for the impact of what it is that we've maybe been engaging in. So I think that's why I love the work that Shatterproof has been doing around storytelling and around sharing those narratives. Because that starts to me, and I mean it builds on, shameless plug, it builds on the work we've started doing here with The Mayo Lab Podcast in season one, and how we've built out a lot of that work.
But it to me brings to life what you're talking about. It's really hard to say, "That person is..." Blah, blah, blah, blah, blah, when you put a face to that name. When it's, "So-and-so's mom or dad or it's my aunt or uncle or my brother or my sister." Or whomever that is, suddenly it's not them anymore. It's me. It's us. And I think that is what the power of what y'all are doing really gets to. Because I would guess, and I haven't done this, but I would guess that if you were to call out that disconnect that people talk about in the work that you've done between, "Yeah, treatment's great, but not near me." They would be really upset because they'd be like, "You're calling me out. You're making me look bad." But they haven't really done the thinking through of what the implications of what they're talking about here are. And I think finding ways to do that in a gentle and kind way without making them get their backs up against the wall, that's how we begin to chip away at some of this work.
But I'd be curious to know what else Shatterproof has been doing in that space to start to chip away at stigma. The reality is, stigma's been around forever and a day. This is not new. Just like addiction is not new, stigma is not new. This is kind of part of the human condition, but it's one of those know better, do better scenarios. So what do we know better now and how are we doing better in this space?
Courtney McKeon:
Yeah, so I think that when we first implemented the Shatterproof Addiction Stigma Index, unfortunately, it just reaffirmed that stigma is alive and well. And to your point around us, I would say all of us, not really appreciating what stigma is or how we are perpetuating stigma in our everyday life, we will go and have conversations with many different people and they'll be like, "Oh, we don't have stigma. We don't have stigma." And I think one of the things that Shatterproof is doing differently to approach this issue is we are measuring everything. So let's get a baseline and understand. You say there's no stigma. Great, let's go ahead and evaluate your state and see. And unfortunately, it comes back and there is a lot of problematic attitudes and misinformation around substance use disorder.
What we do then is we use that information along with, I would say, coupled with, community needs assessments because they are so crucially important. To just what you were saying, we see this disconnect come up not just quantitatively, but qualitatively. People are like, "Yes. Not in my backyard, because the person with substance use disorder looks like what they display on Law and Order every night." And it's like, "No, that's not the truth." And so we collect dozens and dozens of stories, and that's different than any regular communications campaign because a lot of communications campaigns will only invest in 1, 2, 3 stories and have almost like a poster individual for a campaign. We want to show substance use disorder shows up everywhere. Like you said earlier, it's not unique. Over 16% of the US population age 12 and over met the criteria for substance use disorder in 2021. And I would say over 40% of US adults say that their family member or close friend has been navigating substance use disorder or addiction in the past.
So we know people who have this substance use disorder. So putting a face and showing people that they can work with you, they can live next door to you, they can lead productive lives. And one of the things we're trying to do with our narrative, our story arc if you will, is show people not so much a black and white journey where it's like, "I had substance use disorder and I manifested all of these stereotypes around substance use disorder. I wasn't trusted. I wasn't able to be trusted. I couldn't manage my own money." Whatever the stereotype might be, and then show a story where, "Well, now I'm in recovery and I'm this great person." It's like, no, it's not black and white. These people are the same exact people, whether in active use or in recovery. Really understanding that it's a medical condition and they can live productive and prosperous lives in recovery.
But I find that a lot of stories still almost other people who are using drugs. And I don't know the magic answer to this, but it's definitely something as we think about all the harm reduction efforts that are going on around Naloxone and fentanyl test strips and those types of things is how do we also not other people who are trying to find their way to recovery? So that's one of the things that we do everything as evidence-based or research informed as possible. So how do we create a research question and try to better understand what that would look like? And then we always measure at the end of a campaign, we want to see, "Did we see measurable change in stigma?"
People are always, like you said, "What is stigma?" It's just like this thing, but no one can put their finger on what it is. But by measuring it and asking the questions, we can say that we, donor, state government, opioid [inaudible] dollars are seeing a return on investment because we're actually seeing measurable shifts at 12 months. We just had some really successful results in our UNSHAME Kentucky campaign where we saw a decrease of 10% in public stigma of people who were exposed to our campaign in just one year.
Meagen Rosenthal:
Wow.
Courtney McKeon:
So very exciting.
Meagen Rosenthal:
That's huge.
Courtney McKeon:
It's huge.
Meagen Rosenthal:
That's huge. No, that's enormous. For some context, for those of you all who might be listening who don't speak researcher and statistics, think about it like this, right? So if you saw a 10% reduction in your weight, for example, if you were a person who was at risk of something like diabetes or high blood pressure or had that high cholesterol, if you saw a 10% reduction in your weight, you're looking at getting out of the pre-diabetes category to being healthy-ish. If you saw a 10% reduction in your A1C level, if you're a person who has diabetes, that can take you from having to take a metformin every day to not having to take a metformin every day anymore.
So these are huge numbers, and I'm glad that we're actually seeing and having the opportunity to measure that change because I think that's something else that folks listening might not appreciate about the tool that Shatterproof has created. There have been lots of tools in existence over time that measure stigma. And I say whoop-de-doo. We know stigma exists. But measuring it in a way that allows us to track change over time, that's where the money is, right? We don't want to just know that it exists. We want to know that we can do something about it. And that's the really cool thing about the tool that y'all have been using is that now as you evidenced in Kentucky through the campaign that y'all just did, you've been able to measure a 10% reduction for those folks who were exposed or who saw the advertisements that you all had shared. And I think on a hopeful note, that's where this matters most.
I think that when people listening and thinking about the use of language, circling all the way back to where we started, the idea of person-first language, and on all of these, it gets maybe sometimes a little much, right? Like, "Oh, I have to think about one more thing that I can't say anymore that I used to say." And blah, blah, blah, blah, blah. I get it. I totally get it. But when you can see that changing the language, changing the story, changing how we think about a group of people who are our neighbors, our brothers, our sisters, our moms, our dads, our aunts, our uncles, part of our community, matters. It matters in reductions in how we treat these folks. It matters in reductions in helping them get into recovery and staying in recovery long-term, despite the fact that, look, human beings are human beings. We're going to have ups and downs and peaks and valleys, and that's part of the normal human condition, extending that grace.
But what we do in this space matters, and it matters in a measurable way. And I think that is my plea to our listeners that this stuff does matter. It matters how we talk about it. It matters how we engage with people. It matters how we think about it. And that really is the starting place for all of this is how do I think about this population of people and how I would like to engage with them? And then that trickles down into all of those other spaces. There's just so much in here. But I think as we're wrapping you ish, Courtney, what is one thing that you wanted to talk about today that maybe we haven't covered yet? Do you have any other secret tidbits that you think that our listeners would love to hear about? I mean, really in fairness of anything you say would be fine. So no pressure.
Courtney McKeon:
Okay. So I think that one of the things that you hit on and that we're finding in our work is that the opposite of addiction is connection. So that's the way we like to think about our campaigns and the messages that we are sharing. We want to inspire hope. We want to create connection between communities. And some of that connection is physical connection, and some of it is mental connection and crossing the T's and dotting the I's for someone on some of the things that they just might have not known or have had misinformation on for years. So that is one of the things that I would bring up and say that we should show kindness and compassion to everyone we meet. And I know that sounds so cliche, but it's so true. And you just never know what someone is navigating or what they're going through no matter what the condition. And you don't know what a nice gesture or nice using person-first language, what that can do to their self-esteem and how that can really be catalytic on a journey to recovery.
The other thing that I think of as a parent, I was actually being interviewed for a good documentary about a month ago, and the question came up and it was like, "As a parent, how are you going to talk to your children about substance use disorder?" I'm like, "Whoa, whoa." I'm in this field and I have a family history of substance use disorder, and yet I was stumped. I was like, "My kids are five and younger. I haven't even began to think about what talking to them about substance use disorder and anything related to this topic could look like." So with preparing for that interview and having some conversation just on the fly during that interviewing process, there are some strategies out there for parents to really think about how they can start to have these conversations.
One of the things that we've talked about is building social resistance skills, how to teach your kids to be assertive in high risk situations. It's kind of, as we had mentioned before, it's kind of going against the grain and not succumbing to social pressure and also normative education. So having your children really understand what are the real rates of people your age using substances? It's one of those things where it can feel like everyone is, especially at a young age, everyone's experimenting, everyone's doing that thing. But if you can provide just the facts to them on the issue, it can help lower the social pressures that they feel. And then I would say too, talking about how do you teach your kids coping strategies?
We talked about at the front end of the podcast, right? A lot of substance use or misuse can start, there's multiple avenues in which this can start, but a lot of it can be, as I say, simple, it's probably not the best word, but as simple as not being able to cope with trauma or not being able to cope with something that has happened in your life. And we think about if we take time to really focus on helping young people build their self-esteem, problem solve, help them build their decision-making skills, helping them improve their interpersonal skills, all of that will help them when it comes to coping with stress and anxiety, which we also know that can be a leading indicator to someone starting to use or experimenting with substances. So those are some of, I would say, the tangible things that we talked about as you think about diving into the conversation.
And then from a personal standpoint, the thing that I really feel passionately about is transparency. And yes, at every age transparency can look a little different, right? What I say to my kid at five is not the same thing I'm going to say to her at 15, but building that relationship so she feels comfortable coming to me and talking to me and know mom's going to give her the real answer I think is going to pay dividends in the long run as we think about whether she calls me if there's someone who is driving and is under the influence. How do you create those relationships with? It's really about building that foundation at this age with your child to trust you and come to you even when it's uncomfortable or even when it's not the thing that they want to talk to mom about. So I think those are the types of things that I wanted to also hit on as you think about being a parent of a young child or young person trying to navigate life, right?
Meagen Rosenthal:
I think that's fantastic, and I'm going to invite you to listen to the rest of season two of The Mayo Lab Podcast here, in terms of this fall series of episodes, because we're going to be talking to some other people this upcoming fall, they're going to be talking exactly about what you said. How do we build self-esteem in our kids? How do we have the conversations with them and encourage the conversations with them about, "You can call me if something goes wrong." And my first reaction is, "You're toast buddy." How do you have that relationship with your kids in a practical way, right? Because it's one thing to say, "Oh yeah, no, I should be transparent with my kids and have that conversation with them."
But it's a really different thing to actually do it in practice. As you said, what you say to a five-year old is not what you say to a 15-year-old. Or shouldn't be. And vice versa, right? What I say to a 15-year-old probably shouldn't be spoken about to a five-year-old in the same kind of way. So we're going to be getting into some of those discussions for the remainder of this season. So I'm very excited. We didn't plan that at all. So well done picking up on that invisible cue.
And on that note too, I think the final question I would have for you, and it's actually a series of three questions, but you could break it up however you want. One of the things that we're looking to do this season with The Mayo Lab Podcast is to leave our listeners with a list of things that they could be doing at the end of each episode. So something they can do for themselves around the topic of our discussion today, so it was stigma and substance use disorder. Something they can do for their families, and something they can do for their communities. Now, you've talked about a lot of those, you've got a lot of good tidbits, so you can feel free totally to call back out something you've already said. But we're looking for something you can do as an individual, something you can do for your family or family unit, and something you can do for your community.
Courtney McKeon:
Love that. I love how this podcast is thinking about putting things into practice, because I think sometimes we get hung up on the research and the thing, and we don't think about, well, what is the actionable next step to be part of the solution? I definitely think I would be remiss if I didn't say a lot of what we talked about today, use person-first language. There are a lot of great language guides out there that don't just tell you, "Say this, not that." But they explain the why and they give you the research. So Shatterproof has a great one, but there are plenty out there. So I think that is one of the things that I would drive home.
Educate yourself and others. So kind of going back to this gentle call out. I try to do that in all of my interactions. If I'm at the hairdresser and I'm getting my hair done and I tell her what I do, and the subject comes up around substance use disorder or addiction, lots of times the stories start to flow and they start to tell us about the person they know who has been impacted by substance use disorder. And in that, whether it's using stigmatizing terminology or reiterating that, "This person made a choice, that they're a bad person", I take that opportunity as my way of educating others to say, "You know what, actually, instead of saying that word, you should say this word, and this is the reason why." Or, "Actually, did you know that substance use disorder is a treatable medical condition? Just like would you be talking about someone who had diabetes in the same way?" Trying to make the connections for people, educate and meet them where they're at. In my opinion, that type of work, there's a domino effect to it. You tell one person, hopefully, my goal is that next time they hear someone talking, they'll help inform them, or they'll be intrigued to start doing their own research to better understand what the misinformation is that they might have around substance use disorder.
And the other thing that I would say is we all love TV. We love TV no matter what the form is, right? Whether it's a series or a movie or the news. The one thing that I would like people to start thinking about is how have you been influenced by media narratives or stories? And how have they maybe illustrated what substance use disorder looked like in a negative light? So we think a lot about the imagery that's used or the words that are used, and we don't take the time to really reflect and internalize how that might be shaping what we think. So I think I would tell people to sit with that, reflect on it, and see how the media might be more heavily influencing their view on this issue than they should. What internal biases do people have and where is that coming from? I think a nice reflection exercise is really helpful to get to the root of why do you feel this way or think this way about this disease?
Alexis Lee:
That is probably my favorite.
Meagen Rosenthal:
Mm-hmm. Absolutely. Absolutely.
Alexis Lee:
So good. So good. And for everything Courtney just said, for links to verbiage, all the things, we will have in the show description, on our website, on our social media for guides, helpfulness in that sense, and also link to Shatterproof so people can check out Shatterproof and learn more about what they're doing and also some of these amazing opportunities to inform their public.
Courtney, thank you so much for joining us on The Mayo Lab Podcast. This has been such a sweet episode I know for both of us. So we're so excited you were able to come and join us, and we're just so grateful.
Meagen Rosenthal:
Thank you.
Courtney McKeon:
Thank you for having me. And also thank you for highlighting just such an important issue. I'm really excited to see what you have in store for the rest of the series.
Voiceover:
Thank you for joining us on this episode of The Mayo Lab Podcast. The Mayo Lab Podcast is produced by Dr. Natasha Jeter, Dr. Meagen Rosenthal, Alexis Lee, Slade Lewis, and Hannah Finch. This podcast was recorded at Broadcast Studio in Oxford, Mississippi. The show was mixed and mastered by Clay Jones, and our original music was composed by Slade Lewis. The Mayo Lab Podcast is brought to you by the William McGee Institute for Student Wellbeing. For more information on The Mayo Lab Podcast, head over to themayolab.com and follow us on social media @TheMayoLab. If you enjoyed listening to The Mayo Lab Podcast, we'd love for you to subscribe, rate, and give a review on iTunes, Spotify, or wherever you're listening to this podcast. This podcast represents the opinions of Dr. Meagen Rosenthal, Alexis Lee, and their guests on the show. This podcast is not intended to be a substitute for the medical advice of a licensed counselor or a physician. The listener should consult with their mental health professional in any matters related to his or her health, or the health of a child.
Sources & Resources:
Website: Shatterproof
Shatterproof is a national nonprofit working to reverse the addiction crisis. Their three pillars are transforming the treatment system, supporting and empowering communities, and ending the stigma of addiction.
Website: Shatterproof Addiction Stigma Index
Guide: Shatterproof Stigma Addiction Language Guide
Website: The Mayo Lab
Website: William Magee Institute
Instagram: The Mayo Lab
Facebook: The Mayo Lab
Article: What is the DSM-5?
Article: DSM-5
