Pop quiz: True or False?

  1. Addiction is a moral problem.
  2. People with substance abuse disorders choose to continue using drugs.
  3. Addiction is not a health condition and those addicted are to blame for their problems.

Answers:  False, false, false.

But each statement reflects common, widely-held attitudes and prejudices.

We all feel helpless reading the headlines about the opioid epidemic tearing across America like an out of control wildfire. Imagine how people suffering from this disease feel.

But every one of us is responsible for its spread.

Yes, you. And me. Everyone around us. From legislators, to health plans and the healthcare community, to our individual communities everywhere.

All of us are responsible for helping to perpetuate the tragedy hitting every part of this country in appalling numbers. That’s because an overwhelming obstacle standing in the way of effective treatment to patients with addiction – especially opioid addiction – is one simple thing:


Most people still suspect that opioid addiction has something to do with a deficient moral character or lack of willpower. Addicts are junkies. They’re not like you and me.

People with opioid use disorder are exactly like you and me. They are our sons, our daughters, parents, friends, and professional colleagues. Thinking otherwise feeds the stigma.

Which is why every day, in my work leading a company that provides outpatient medical treatment for opioid and alcohol use disorders, I have to address this fallacy with an unwavering conviction and the same strength and courage that our patients, their families, and friends have in taking the first step to managing their disease.  

Patients with opioid use disorder (and they are patients, not addicts) suffer from a chronic relapsing brain disease that can and must be medically treated to achieve lasting recovery.


Daily, relentlessly, the caring employees at CleanSlate Centers battle the accelerating effect that stigma has in fanning the flames of the opioid firestorm. We see firsthand the shame and self-criticism that patients and would-be patients, families and friends feel, and how it creates barriers to ending depression and beginning treatment and recovery.

Stigma is the reason why some doctors won’t treat patients. It’s the reason why some pharmaceutical companies won’t develop new treatments. It’s the reason why many health plans still differentiate between physical and behavioral health benefits.

Stigma kills, plain and simple.

Doing what has always been done is not good enough. Do we object to a diabetic who seeks insulin treatment? A cancer patient who pursues chemotherapy? Of course not.

Why, then, are patients with substance use disorders subjected to merciless societal judgements that keep them isolated, sick, incarcerated, and dying? Why are people with brain diseases expected to just will their way to wellness, when in fact their chances of relapsing are deathly high if they don’t receive ongoing medical treatment as a part of their recovery?

Evidence has mounted in the treatment of opioid use disorder and the hard data is incontrovertible. Yes, many patients need additional services in conjunction with medical oversight, as the disease of addiction is not binary. But to prevent a relapse they should also receive FDA-approved medication (such as buprenorphine or naltrexone, which CleanSlate clinicians prescribe). These medications mitigate withdrawal and cravings by interacting with brain receptors which have been forever damaged because of addiction.   

Patients may need ongoing, outpatient medical treatment for years to prevent a relapse. And this shouldn’t carry a single ounce of emotional baggage. There is no difference between a patient with opioid use disorder managing her disease through regular doctor’s appointments and a patient who needs ongoing physical therapy appointments.

What will it take to end the stigma surrounding addiction? Storytelling. We must all dig deep and find our courage and voice, and provide safe platforms for patients, families and friends to share their stories.

Healthcare professionals, individuals, families and community stakeholders – including public safety officials, first responders and spiritual leaders – all of us who are affected by addiction need to speak out, destroy myths and correct misconceptions. Addiction and substance abuse must be elevated in the national conversation with facts and real stories to change beliefs, biases and behaviors. We cannot be afraid and we can’t be a part of the problem. Medication-assisted treatment (MAT) support groups can be found throughout the country such as the MAT support group in Worcester, Massachusetts that are raising awareness every day.

We must stop looking to blame someone or something and instead take responsibility. It’s time to flood the zones of our communities with treatment, compassion, education and collaboration.

As with any disease, opioid use disorder patients do not choose to suffer from addiction. Every one of us has a role to play in destigmatizing addiction and restoring dignity and hope to those in the grips of this deadly – but curable – disease.   

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Greg Marotta

Greg Marotta is the President and CEO of CleanSlate, a leading national medical group that provides office-based outpatient medication treatment for the chronic disease of addiction, primarily alcohol and opioid use disorders.