The New York Times is dead wrong about drug addiction

The paper of record's insensitive approach only reinforces destructive stigmas

Topics: Drug Addiction, The New York Times, Suboxone, Buprenorphine, Harm Reduction, Drug abuse, War on Drugs, , ,

The New York Times is dead wrong about drug addiction (Credit: Reuters/Shannon Stapleton)

In a two-part series for the New York Times last month, Deborah Sontag wrote about buprenorphine, a medication used (mostly in the form of Suboxone) to treat opiate addiction through replacement therapy. The piece was presented as a dramatic exposé, with the flashy headline: “Addiction Treatment with a Dark Side.”

But Sontag missed the mark by ignoring the concept of harm reduction and relying on the outdated view of addiction as a moral failing. Her politically correct language conceding that addiction is a “disease” is belied by descriptions of patients “cheating” on their treatment — um, we call it “relapsing” — plus an emphasis on the black-market distribution of the opiate substitute and a lack of attention to the real-world effects of drug use.

Then last week, Andrea Elliott wrote a well-intentioned five-part series for the Times profiling a homeless girl named Dasani living with her family in a Brooklyn shelter. Hidden in this highly-trafficked piece was even more demoralizing language about drug users, a population already besieged by stigma. Dasani’s parents are on opiate-replacement therapy — in their case, methadone, not the newer Suboxone. Rather than explore the positive correlates of the treatment for Chanel and Supreme (Dasani’s parents), Elliot writes dismissively that their treatment has merely “become a substitute addiction.” This language echoed Sontag’s earlier description, that “Buprenorphine has become both medication and dope.”

People struggling with opiate addiction are more than familiar with that disparaging sentiment. At the community mental health clinic where I work in Greenfield, Mass. (a hotspot of opiate use), clients on opiate-replacement therapy struggle daily with feelings of shame that their recovery “doesn’t really count.” They fear they are not really “clean.” That kind of shame is exactly what can (and does) lead to relapse.



But in spite of the stigma and shame, I also hear clients tell me about a plethora of positive outcomes that result from their treatment, none of which were highlighted by Sontag. She missed how, especially at this time of year, clients are relieved to have money (which they were once spending on heroin or expensive painkillers) to buy winter clothes for their kids. They’re also grateful to no longer be at risk at risk for HIV, Hep. C, and abscesses — diseases and infections that drug users contract through sharing needles or having unprotected sex in exchange for drugs. Lastly, these clients know that they are no longer at risk of overdosing during unmonitored drug use. (Two people die from opioid overdoses every day in Massachusetts, more than the number that die from car accidents.) Though Sontag may say that buprenorphine is “dope,” there are crucial differences between the two in ways that matter to the people actually involved, like money and safety from life-threatening disease, not to mention risk of arrest and incarceration.

Plus, buprenorphine is very unlikely to cause impairment. Yes, it’s a “drug,” like all medications are — newsflash: they mean the same thing — but a person can be in complete recovery from addiction and still take it. As Maia Szalavitz explains:

Addiction is not physical dependence on a drug. If it was, we’d have to consider all diabetics as “insulin addicts” and people who need antidepressants long-term as “antidepressant junkies.” Instead, psychiatry defines addiction as compulsive use of a drug despite negative consequences. If the use isn’t compulsive and the consequences are positive, the addiction has been resolved even if the physical dependence remains.

In hyping up the “black market” and “misuse and abuse” of buprenorphine, Sontag doesn’t acknowledge that the market is largely driven by lack of access to the very same treatment. I see clients who started out buying Suboxone on the street from their peers, and using it correctly until they could get into official treatment. Some clients also start out buying Suboxone on the street because they’re too ashamed to be seen going into the clinic; it’s a small town. For me, as well as other health care workers and activists who are actually in the field, it’s clear that reducing stigma around addiction treatment, not increasing it, is the way to save lives.

In the future, it would be better for journalists writing about addiction treatment to at least explain the thinking behind harm-reduction approaches like Suboxone. They can agree or disagree with that thinking, but to ignore it seems at best ignorant, at worst willfully misleading.

Harm reduction, as explained by groups like the Harm Reduction Coalition, is based on an acceptance that drug use is part of our world. Its proponents choose to work to minimize the harmful effects of drug use (like HIV, Hep. C, addiction and incarceration) rather than simply condemn it as immoral in and of itself. Harm reduction proponents also accept that drug use happens in the real word, where it intersects with inequalities like systemic racism and poverty. Yet, just as the long article ignores diseases that drug users are at risk for, there’s no mention in the piece of the ways that race and class intersect with drug use: Two-thirds of people incarcerated for drug offenses in state prisons are black or Latino, although these groups use and sell drugs at similar rates as whites. A black male is sentenced to a prison term  that is, on average, 20 to 50 times longer than that of a white male convicted of the same drug crime. And class matters too, of course. As Ethan Nadelmann, director of the Drug Policy Alliance, has said, “Wealthy people who struggle with addiction often can deal with it in a private setting. Poor people can often only access treatment through the criminal justice system.” Like many treatments, Suboxone may be imperfect, but why ignore the benefits, like its potential for keeping members of vulnerable populations out of jail?

Harm reduction is all about erasing the idea that addiction is a moral failure — that people addicted to a drug are “dirty,” while other people are “clean” — and taking a public health perspective that focuses on what can actually save lives and lessen damage to families. The first step is encouraging and supporting people who are getting any kind of help, not making them feel worse for it. As my client who takes Suboxone recently said to me: “Why can’t it be a good thing to tell people I’m in recovery? Instead, I have to hide it.”

I really hope she doesn’t read The New York Times.

Sarah Beller has written about addiction and harm reduction for The Fix. Her writing can also be found at The Hairpin, The Toast, Psychology Tomorrow and other publications.

More Related Stories

Featured Slide Shows

  • Share on Twitter
  • Share on Facebook
  • 1 of 14
  • Close
  • Fullscreen
  • Thumbnails

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and Adam, "Pilot"

    One of our first exposures to uncomfortable “Girls” sex comes early, in the pilot episode, when Hannah and Adam “get feisty” (a phrase Hannah hates) on the couch. The pair is about to go at it doggy-style when Adam nearly inserts his penis in “the wrong hole,” and after Hannah corrects him, she awkwardly explains her lack of desire to have anal sex in too many words. “Hey, let’s play the quiet game,” Adam says, thrusting. And so the romance begins.

    13 of "Girls'" most cringeworthy sex scenes

    Marnie and Elijah, "It's About Time"

    In an act of “betrayal” that messes up each of their relationships with Hannah, Marnie and Elijah open Season 2 with some more couch sex, which is almost unbearable to watch. Elijah, who is trying to explore the “hetero side” of his bisexuality, can’t maintain his erection, and the entire affair ends in very uncomfortable silence.

    13 of "Girls'" most cringeworthy sex scenes

    Marnie and Charlie, "Vagina Panic"

    Poor Charlie. While he and Marnie have their fair share of uncomfortable sex over the course of their relationship, one of the saddest moments (aside from Marnie breaking up with him during intercourse) is when Marnie encourages him to penetrate her from behind so she doesn’t have to look at him. “This feels so good,” Charlie says. “We have to go slow.” Poor sucker.

    13 of "Girls'" most cringeworthy sex scenes

    Shoshanna and camp friend Matt, "Hannah's Diary"

    We’d be remiss not to mention Shoshanna’s effort to lose her virginity to an old camp friend, who tells her how “weird” it is that he “loves to eat pussy” moments before she admits she’s never “done it” before. At least it paves the way for the uncomfortable sex we later get to watch her have with Ray?

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and Adam, "Hard Being Easy"

    On the heels of trying (unsuccessfully) to determine the status of her early relationship with Adam, Hannah walks by her future boyfriend’s bedroom to find him masturbating alone, in one of the strangest scenes of the first season. As Adam jerks off and refuses to let Hannah participate beyond telling him how much she likes watching, we see some serious (and odd) character development ... which ends with Hannah taking a hundred-dollar bill from Adam’s wallet, for cab fare and pizza (as well as her services).

    13 of "Girls'" most cringeworthy sex scenes

    Marnie and Booth Jonathan, "Bad Friend"

    Oh, Booth Jonathan -- the little man who “knows how to do things.” After he turns Marnie on enough to make her masturbate in the bathroom at the gallery where she works, Booth finally seals the deal in a mortifying and nearly painful to watch sex scene that tells us pretty much everything we need to know about how much Marnie is willing to fake it.

    13 of "Girls'" most cringeworthy sex scenes

    Tad and Loreen, "The Return"

    The only sex scene in the series not to feature one of the main characters, Hannah’s parents’ showertime anniversary celebration is easily one of the most cringe-worthy moments of the show’s first season. Even Hannah’s mother, Loreen, observes how embarrassing the situation is, which ends with her husband, Tad, slipping out of the shower and falling naked and unconscious on the bathroom floor.

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and the pharmacist, "The Return"

    Tad and Loreen aren’t the only ones to get some during Hannah’s first season trip home to Michigan. The show’s protagonist finds herself in bed with a former high school classmate, who doesn’t exactly enjoy it when Hannah puts one of her fingers near his anus. “I’m tight like a baby, right?” Hannah asks at one point. Time to press pause.

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and Adam, "Role-Play"

    While it’s not quite a full-on, all-out sex scene, Hannah and Adam’s attempt at role play in Season 3 is certainly an intimate encounter to behold (or not). Hannah dons a blond wig and gets a little too into her role, giving a melodramatic performance that ends with a passerby punching Adam in the face. So there’s that.

    13 of "Girls'" most cringeworthy sex scenes

    Shoshanna and Ray, "Together"

    As Shoshanna and Ray near the end of their relationship, we can see their sexual chemistry getting worse and worse. It’s no more evident than when Ray is penetrating a clothed and visibly horrified Shoshanna from behind, who ends the encounter by asking if her partner will just “get out of me.”

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and Frank, "Video Games"

    Hannah, Jessa’s 19-year-old stepbrother, a graveyard and too much chatting. Need we say more about how uncomfortable this sex is to watch?

    13 of "Girls'" most cringeworthy sex scenes

    Marnie and Desi, "Iowa"

    Who gets her butt motorboated? Is this a real thing? Aside from the questionable logistics and reality of Marnie and Desi’s analingus scene, there’s also the awkward moment when Marnie confuses her partner’s declaration of love for licking her butthole with love for her. Oh, Marnie.

    13 of "Girls'" most cringeworthy sex scenes

    Hannah and Adam, "Vagina Panic"

    There is too much in this scene to dissect: fantasies of an 11-year-old girl with a Cabbage Patch lunchbox, excessive references to that little girl as a “slut” and Adam ripping off a condom to ejaculate on Hannah’s chest. No wonder it ends with Hannah saying she almost came.

  • Recent Slide Shows

Comments

Loading Comments...