RICARES and the City of Providence Present

Words Matter:

A Conversation About Stigma, Substance Use, and COVID-19


September 25th, 10AM – 12PM

Open Letter to the Rhode Island Press from the Recovery Community and Allies

As Rhode Island struggles with the unprecedented impact of the COVID-19 epidemic, an older and equally devastating epidemic has gotten worse. In 2019, over 300 hundred people in our state died of a drug overdose—the numbers are now increasing for the first time in three years. COVID-19 has thrown gasoline on the flames by disrupting access to treatment, social support, recovery meetings (like AA and SMART recovery), harm reduction supplies like the life saving medication Naloxone, and basic medical care. But the fire was already burning out of control.

Among people who want help for their addiction, perceived stigma from family, friends, and the community is the single greatest obstacle to reaching out for help. We are afraid of losing our jobs when employers find out about our substance use. We fear judgment and abandonment by our families and friends. We worry that doctors will censure, reject, or label us “medication seeking”—blacklisting us from care. We live with shame and self-doubt from a lifetime of hearing that addiction—a serious, but entirely treatable, health condition—is a choice or moral failing.

Looking at research, we see that stigma undermines every aspect of our society’s efforts to address the overdose epidemic. Stigma among treatment providers is linked to mistreatment, lower program completion rates, and worse outcomes. Internalized stigma feeds depression and anxiety that can, in turn, drive more severe and dangerous use. Public stigma leads to support for criminalization rather than care. Stigma, and ultimately the ensuing discrimination, bars people from housing, meaningful employment, and education—the very things that promote successful long-term recovery.

As Rhode Island’s recovery community organization, RICARES is calling on newspapers, televisions stations, radio, and online media to join with the recovery community in tackling stigma in our state. As daunting as this may sound, multiple studies show that there is a free and easy way to build momentum: we need to change the way we talk about addiction and recovery. 

Words like “addict” and “alcoholic” reduce us to a stereotype or diagnosis. Words like “clean” imply that we were tainted and soiled (rather than living with an illness). “Substance Abuse” implicitly compares us with child and spouse abusers. Although it is tradition (and can be personally transformative) for people in recovery to claim these labels, evidence shows that they lead both professionals and the general public to believe we are more deserving of punishment and less likely to benefit from treatment. For these reasons, the Associated Press published new guidelines in 2017 on how to write and speak about addiction in the press.

To jump start this discussion, RICARES has joined with the City of Providence to organize “Words Matter: A Conversation About Stigma, Substance Use, and COVID-19.” A two-hour online workshop, this event will include people in recovery speaking about their experiences of stigma and discrimination, nationally recognized journalists, and world-renowned researchers

Our goal is that three television channels, three newspapers, three radio stations, and three online platforms publicly pledge to uphold the AP guidelines by the end of National Recovery Month, September 2020. We see this as a first step toward all RI news platforms embracing person-centered and medically accurate language. No other state has made this kind of effort. Achieving this goal would make the RI press leaders in the national conversation.

Rhode Island journalists—the recovery community is reaching out to you.
Will you work with us?

We Stand with RICARES 

  • Monica Smith, CEO, RICARES
  • Ian Knowles, RICARES
  • Machiste Rankin, RICARES 
  • Diego Arene-Morely, RICARES
  • Anthony Maselli, RICARES
  • Olivia Jenkins, RICARES
  • Jon Soske, RICARES
  • Lisa Conlan Lewis, Executive Director, Parent Support Network of Rhode Island
  • Jonathan Goyer, RI Recovery Friendly Workplaces
  • Michelle McKenzie, Preventing Overdose and Naloxone Intervention (PONI)
  • Michael Beauregard, Systems Change Solutions
  • Haley McKee, Co-chair, Substance Use Policy, Education, and Recovery PAC
  • Michelle Harter, Anchor Recovery
  • Mark Leeuwenburgh, SMART Recovery*
  • Colleen Daley Ndoye, Project Weber/RENEW
  • Laurie MacDougall, REST
  • Ellen Cynar, Healthy Communities Office, City of Providence
  • Rick Corley, RICARES, Warwick City Councilman
  • Brandon DL Marshall, PhD, Brown University School of Public Health*
  • Leadership Team, Formerly Incarcerated Union of Rhode Island
  • Ryan Erickson, BHDDH*
  • Jody Rich, MD, MPH, The Center for Health and Justice Transformation, The Miriam Hospital*, Brown University*
  • Traci Green, COBRE on Opioids and Overdose at Rhode Island Hospital*, Alpert Medical School of Brown University*
  • Ana Bess Moyer Bell, MA, RDT, COAAST (Creating Outreach About Addiction Support Together)
  • Luis M. Estrada, Jr., Consultant and person in long-term recovery
  • Tyrone Mckinney, Project Weber/RENEW
  • George O’Toole, Anchor Recovery ED & MORE Programs
  • Linda Marzilli, person in long-term recovery 
  • Cathy Schultz, West Warwick Health Equity Zone
  • Lynn Farkas, CPRS
  • Angela Doucette
  • Angel Schultz, AA, LCDP, Addiction Recovery Institute, person in recovery 
  • Nick Horton, Co-Executive Director, OpenDoors
  • Nicholas Smith
  • Jesse Yedinak, Brown University School of Public Health
  • Melissa Sanderson
  • Erin Batherson, SMART Recovery* 
  • Caroline Wunsch, MD
  • Kate Elizabeth Creasey, Donavan Program Coordinator, Brown University*   
  • Gayle Fraser, COBRE on Opioids and Overdose at Rhode Island Hospital
  • Michelle Taylor, Community Care Alliance
  • Sarah Martino, The Center for Health and Justice Transformation, The Miriam Hospital*
  • Jason R. Smith, LIUNA, Local 271*
  • Nathan DeSalvo
  • Deb Dettor, person in long-term recovery 
  • Cherie Cruz, MA, CPRS, CLC  
  • Alfred Brissette BS, CPRS, CCHW, PRS
  • Brandon Bergman PhD, Recovery Research Institute at the Massachusetts General Hospital & Harvard Medical School 
  • Dennis A. Bailer, Overdose Prevention Program Director, Project Weber/RENEW
  • Ryan Hampton, Founder, The Voices Project
  • Roxxane Newmann, person in long-term recovery 
  • Sarah Edwards, Hope CORE Team/Parents Support Network of Rhode Island
  • Albert Turner 
  • Aimee Haupt, Anchor Recovery ED & MORE Programs
  • John M. Bullock Jr.
  • Christa Thomas-Sowers, Community Care Alliance and Serenity Center 
  • Sarah Saint Laurent
  • Annajane Yolken, Substance Use Policy, Education, and Recovery PAC and Project Weber/Renew  
  • Vinnie Velazquez, MS, CAADC, CPRSS 
  • Seth Clark, Lifespan Recovery Center
  • Cara Zimmerman, Brown University/Lifespan Hospitals Internal Medicine Residency Program*
  • Brendan Jacka, Brown University School of Public Health*
  • Brandon del Pozo, The Miriam Hospital*
  • Alexandra Collins, Brown University School of Public Health*
  • Michael Fry, Parents Support Network of Rhode Island 
  • Gary Saint Laurent, Anchor, Recovery Community Center*
  • Jacqueline Goldman, Brown University School of Public Health*
  • Bart Laws, Brown University School of Public Health*; Rhode Island Community-Academic Partnership for Behavioral Health*
  • Lauren A. Hoffman, PhD, Recovery Research Institute, Massachusetts General Hospital & Harvard Medical School
  • Mary Dwyer, Community Care Alliance
  • Eliana Kaplowitz, The Center for Health and Justice Transformation
  • Katie Elmer
  • Maureen Apperson
  • Lisa Peterson, LMHC/LCDP, VICTA 
  • Matt Perry, MD, ScM, Brown University Dept of Family Medicine*
  • Carol S. Cohen, Senior Associate Dean for Health & Personal Issues, Brown 
  • Wendy Ricci 
  • Lori Kosicki, CPRS-Manager Hope Recovery Center of Newport County
  • Erin Goodman, CPRS Washington County Zero Suicide Program*
  • Kate Walton
  • Bernie Quartaroli, SMART Recovery*
  • Sierra Lessing, Operations Coordinator, RICARES 
  • Paul E. Kandarian, actor, Creating Outreach About Addiction Support Together.
  • Lily Rivera, Project Weber/RENEW
  • Nya Reichley, Project Weber/RENEW
  • Kamila Garay, Project Weber/RENEW
  • Rebecca Boss, CODAC*
  • Shannon Spurlock, JSIF
  • Sandra Del Sesto, RI Governor’s Council, Prevention Advisory Committee
  • Andre C. Willis, Brown University*
  • James Shelton, Ancora Acupuncture 
  • Stephen Crocker, Brown University*
  • Steve Gumbley
  • Liz Wiedenhofer, L.I.F.E. Inc. 
  • Patrick Doyle, FamilyAddictionCoach.com
  • Tarshire Battle, Roots 2Empower
  • Lisa Young, Project Weber/RENEW  
  • Aleksei Weaver
  • Prerna Singh, Brown University* 
  • Lori Dorsey, person in long term recovery
  • Miranda Grundy, The Freedom Fighters Podcast, Providence
  • Norman Baker, The Freedom Fighters Podcast, Providence
  • Jairson Ascencao, The Freedom Fighters Podcast, Providence
  • Micah Hall
  • Molly Hall
  • Sara Becker, Brown University School of Public Health*
  • Rob Bohler, Brandeis University* 
  • Steve Reid, Owner, Steel Curtain Boxing and Fitness
  • Abigail Knapton, person in recovery
  • Melissa McGarrahan, Addiction Recovery Institute
  • Kate Fowler, ally
  • Trisha Richard, Jacobs Property Solutions
  • Lynn Mosher, CPRS Supervisor, Serenity Center
  • Paul Makowski, RICARES Board Member
  • Elizabeth A. Samuels, MD, MPH, MHS, Brown Emergency Medicine* and the Rhode Island Department of Health*
  • Amy Larson L., MA Mental Health Counselor, COAAST Drama Therapist, person in recovery
  • Renee Gomes, Parent Partner, Parent Support Network RI
  • Jim McNulty, Executive Director, Oasis Wellness & Recovery Centers of RI
  • Christian Arthur, MSW and person in recovery
    Alexandre Jerard (AJ) Davis, student in long-term recovery
    Kerri Morales, “Cora’s Mom,” The CORA Foundation RI
  • Laurel McIntyre, Brown SSDP
  • Abigail Gulchin, Brown SSDP

* indicates that affiliation is for identification purposes only and does not represent an organizational endorsement of this letter. 

We will continue to add signatures up through September 30st, 2020. To sign, email jsoske@ricares.org

Words Matter: A Conversation About Stigma, Substance Use, and COVID-19

Rhode Island continues to face an overdose crisis. All across the country and in our state, rates of drug overdose are increasing, especially during the COVID-19 pandemic. More than 300 Rhode Islanders lost their lives to an overdose in 2019. In the context of the larger addiction crisis, the widespread use of dated and stigmatizing language when reporting on substance use is a genuine public health concern.
Journalists, anchors, radio talk show hosts, bloggers, and other media figures play an important role in shaping how we talk about substance use, addiction, and recovery. All members of the press are invited to attend this virtual event that will include personal testimony by Rhode Islanders in recovery and professional training by the nation’s leading experts on stigma.

Join RICARES and the City of Providence for a workshop led by veteran journalists, leading researchers, and people in recovery about:

Updated Associated Press guidelines for person-centered and scientifically accurate language regarding addiction and substance use
How the overdose epidemic is impacted by COVID-19 and systemic racism
The importance of using de-stigmatizing language to support connections to treatment and recovery services
Speakers will include Dr. John Kelly (Director, Recovery Research Institute, Harvard/ Mass General), Maia Szalavitz (Nationally recognized journalist and author of Unbroken Brain), Machiste Rankin (RICARES), Ashley Perry (Project Weber/Renew), Diego Arene-Morely (RICARES)
Location: Zoom

Questions? Contact Jon Soske at jsoske@ricares.org

Simultaneous Spanish translation will be provided.

Associated Press Guidelines on How to Write and Speak About Addiction in the Press


Addiction to alcohol and other drugs is considered a disease that affects a person’s brain and behavior. It can cause changes in brain circuits and chemistry that lead to  inability to control use, despite resulting harmful behavior including damage to health and relationships. Genetics, mental illness and other risk factors make certain people susceptible to addiction
Addiction is the preferred term for the disease. The term substance use disorder is preferred by some clinicians and is acceptable in some uses, such as in quotations or scientific contexts. Alcoholism is acceptable for an addiction to alcohol.

Avoid words like abuse or problem in favor of the word use with an appropriate modifier such as risky, unhealthy, excessive, or heavy. Misuse is also acceptable. Don’t assume all people who engage in risky use of drugs or alcohol have an addiction.

Avoid words like alcoholic, addict, user, and abuser unless they are in quotations or names of organizations, such as Alcoholics Anonymous. Many researchers and organizations, including the Office of National Drug Control Policy and the International Society of Addiction Journal Editors, agree that stigmatizing or punitive-sounding language can be inaccurate by emphasizing the person, not the disease; can be a barrier to seeking treatment; and can prejudice even clinicians. Instead, choose phrasing like he was addicted, people with heroin addiction, or he used drugs. 

Examples: Keene had trouble keeping his job because of alcoholism, not Keene had trouble keeping his job because he was an alcoholic. Yang joined other people with heroin addictions at the conference, not Yang joined other heroin addicts at the conference. 

As of early 2017, leading clinicians said disorders with tobacco and gambling can also meet the criteria for addiction. Other compulsivebehaviors such as eating internet gambling, sex and shopping did not meet the clinical criteria for addiction.

When practical, try to confirm that individuals described as having addictions have received such a diagnosis by letting them talk about it themselves, or get confirmation from a doctor or relative in the position to know.

Do not use the terms addiction  and dependence interchangeably. Addiction  usually refers to a disease or disorder; dependence may not invovle one, such as some babies born to mothers who use drugs or cancer patients who take prescribed painkillers.

Note the subtle difference between prescribed and prescription drug.Prescribe usually is used to describe specific drugs a doctor has authorized for a patient; prescription refers to classes of drugs meant for that purpose. The cancer patient took prescribed painkillers. Health officials observed wide misuse of prescription painkillers.