Campaign Tackling Stigma Finds Success by Being Deliberately Different

Shatterproof, a national not-for-profit organization focused on ending the nation’s substance use disorder (SUD) epidemic, has found that 7 of the 9 most frequently cited drivers of SUDs are propelled by stigma, either entirely or at least in part.

In 2020, the organization partnered with The Public Good Projects, Penn State University, and the Pennsylvania Department of Drug and Alcohol Programs to launch an evidence-based SUD stigma reduction campaign known as Life Unites Us. Representatives from each organization joined forces at the recent Rx and Illicit Drug Summit in Atlanta, Georgia, to present findings from the first 12 months of the program.

One of those presenters, Shatterproof CEO Gary Mendell, spoke with Addiction Professional by email to explain how Life Unites Us differs from other stigma-reducing initiatives, what its organizers learned from the campaign’s first year, and what tactics can be replicated by other programs.

Editor’s note: This interview has been edited for length and clarity.

Addiction Professional (AP): What aspects of Life Unites Us set the campaign apart from other programs that have attempted to address stigma?

Gary Mendell: Across the US, there’s more than a handful of campaigns that address stigma. However, from the onset, the Life Unites Us campaign was deliberately designed to be different. Five key aspects set it apart from others and contribute to its success:

• Everything we do is evidence-based and rooted in best practices and research.
• This is a collaborative effort between groups who are leaders in their fields. We each have a role to play and we play to our strengths.
• We make it a priority to include the recovery community in all we do. We do this through a formal Community Impact Committee, which meets on a regular basis to evaluate the campaign and materials, and helps guide the decision-making process for campaign activities.
• We structured the campaign with the ability to be flexible and adapt to external factors and results of regular systematic evaluation. We know that over time, usage trends and populations most affected might change so we built in flexibility to our long-term plan.
• We provide tools and resources to our audience so that they can effectively reduce stigma in their local communities.

AP: What did you learn in the first year after the program’s launch?

Mendell: While the campaign showed success during the first year, there is still much more work to do and improvements that can be made. One thing we learned was that there was a need to target medical personnel and healthcare providers, as they are often the first people a victim of an overdose will see. By better informing these healthcare workers on the stigma that exists and the importance of encouraging treatment, we open the doors for an individual to get the help they need.

AP: How are you measuring the impact the campaign has had? Do you have results you can share?

Mendell: We measure the impact of the campaign with a variety of tools such as social media and web metrics reports, participant and stakeholder feedback, statewide surveys to assess levels of stigma throughout the commonwealth every 6 months, and regularly meet with focus groups to really peel back the outside layers and uncover additional information that our team and past research has not yet identified. Utilizing this evidenced-based approach, rigorous ongoing mixed-methods research techniques, and continuous feedback from community stakeholders, allowed our team to evaluate levels of stigma throughout the state during the first year of the campaign. Findings from our statewide survey found positive trends in:

• Pennsylvanians’ willingness to live with someone with an opioid use disorder (OUD), as well as to continue a relationship with a friend struggling with an OUD.
• Across the state, Pennsylvanians indicated a higher willingness to provide naloxone to friends and family members, and even an openness to having opioid treatment centers located near their homes.

Specifically, those who had viewed the campaign more often agreed that:

• The opioid epidemic is a serious problem in their community.
• Medication-assisted treatments are effective for OUD.
• Their local government has strong policies, and their communities have programs to help support people with an OUD.
• And they are more supportive of harm-reduction strategies.

AP: Are there best practices from your efforts that can be implemented or replicated elsewhere?

Mendell: Positive changes in knowledge, attitudes, and behaviors to reduce stigma don’t happen overnight, by chance, or through the work of siloed stakeholders. For campaigns to be effective, a few best practices should be kept in mind. Specifically, we recommend using the key aspects outlined above as guideposts for future initiatives to address SUD.

Reference

Mendell G, Kensinger W, Smyser J, Smith J. A movement to end addiction stigma: background, implementation, and 1-year outcomes of the collaborative life unites us stigma reduction campaign utilizing the Shatterproof strategy. Presented at: Rx and Illicit Drug Summit; April 18-21; Atlanta, Georgia.