Recovery thought-leader, Sandy Rivers* has raised an interesting question about stigma. Over on LinkedIn, she asks: “How do you think changing our attitudes about SUD can impact stigma?” (https://tinyurl.com/Rivers-LinkedIn-Jan-2026) Sandy avoids the word “addiction,” which is currently viewed by tastemakers as – yes! -stigmatizing.
It’s a great question. One that leads highly motivated activists to “share their story.” Or “self-disclose,” as the clinicians say. Ugh; horrid phrase. Sounds like something you’d do in a cop shop. The idea being that personal testimony will melt the hardened heart and, ultimately, abolish stigma.
Well, good luck with that, as the Americans say.
I fell into this very trap. Back in old country, I became the face of a controversial social cause through testifying at a contentious public meeting. The usual carnival ensued and I was widely quoted in the media. I have no evidence whatsoever that this exhausting parade changed a single mind, but the usual insults were forthcoming. Lenny Bruce gave me strength, and my heart was warmed by receiving a Miraculous Medal from one concerned woman, a token I cherish. (If you know, you know.)
I won’t make that mistake again.
Perhaps it’s different in the U.S., but I’m not convinced. On a recent visit to a prominent treatment agency, a supervisor – indifferent to my status as a representative of what I insist on calling the “peer recovery profession” – blithely referenced her colleagues thus: “Those peers. Just waiting for an excuse for their next use.” She was referring to staff members holding professional CRPA** certifications, most claiming addiction recovery status, and her remarks were based on no documentary evidence, just prejudice. Or stigma, as Sandy might say.
It doesn’t end there. Sandy reports that traditional recovery venues may themselves be stigmatizing: “Much of this [healing] work [giving someone a place to truly tell their story] still happens quietly, behind closed doors, in church basements and meeting halls, unintentionally reinforcing the stigma surrounding substance use disorder.”
Yikes!
Where should we meet? The beach? Well, 12-Step meetings happen on the sand. A public park? Ditto. I would suggest that it’s the person looking crooked at individuals entering undercrofts who are doing the stigmatizing, not the buildings.
At national level, the Health Insurance Portability and Accountability Act of 1996 addresses these issues in the clinical setting. “HIPAA is a federal law that […] was enacted to ensure the privacy and security of health information, facilitating the electronic exchange of health data while safeguarding patient rights.” (Emphasis added) (https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)
If we agree that addiction is a medical condition, as in the Substance Use Disorder (SUD) designation, we should expect that these privacy and safeguarding principles extend into our ordinary lives where we’re discreet about our overall medical status. That is, we are due the same privacy standards, not an (unintentional) expectation that – in (unproven) interests of the greater good – we will expose ourselves and our private healing process to an (unimpressed) public.
Privacy does not equate with isolation. Alcoholic Anonymous’ 12th Tradition, read at every meeting, exhorts group members to confidentiality (anonymity) for the same purposes as HIPAA (privacy and safeguarding). That is, to support their personal healing, members bring their unexpurgated stories to the group for witness on the explicit undertaking that everyone will respect their privacy. Where this happens physically is a logistical matter resolved per local real estate options, not by stigma worries.
This tradition also encourages humility – no member, or her story, is more important than another. Some of the feedback I got years ago was of the “who does she think she is” variety, a rubbishing of the self-disclosure strategy if ever there was one. It’s a valid objection. There’s wisdom in discretion. A life of dignity and integrity may speak louder than any TikTok.
At least, this seems to be the alternative strategy favored by a majority of the estimated 23m+ Americans in addiction recovery who quietly pursue their everyday lives far from the madding crowd, as the poet has it. You’ll find many of them in church basements.
Quite simply, in the words of the old song, my recovery status, my medical history, and my personal experience, “Ain’t nobody’s business but my own.”
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Next up: Stigma lives personally but acts publicly. Part 2 of this two-part essay series, coming soon.
* Full disclosure: I have the honor of training with Sandy and her long-term training partner, Lisa Ardner. They are compassionate professionals for whom I have the highest respect and regard. See, A Purpose 4 Life Evidence-Based Professional &Workforce Development Training.
** Certified Recovery Peer Advocate, the NYS peer recovery support specialist credential (IC&RC via OASAS)
