Originally Published on The New England Journal of Medicine

Each day in 2018, an average of 185 people in the United States died from a drug overdose. In fact, recent declines in U.S. life expectancy are being attributed to direct and indirect effects of alcohol and drug use disorders.


Expanding the number of people receiving evidence-based addiction treatment is crucial for reversing these trends. But among the many challenges in delivering appropriate care to the nearly 20 million people in the United States with substance use disorders is the chilling effect of stigma. Stigma not only impedes access to treatment and care delivery; it also contributes to the disorder on the individual level.


Stigma associated with many mental health conditions is a well-recognized problem. But where considerable progress has been made in recent decades in reducing the stigma associated with some psychiatric disorders such as depression, such change has been much slower in relation to substance use disorders