Does news coverage of opioids reinforce stereotypes about addiction?

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Before joining Berkeley Media Studies Group in 2010, I was the health and science writer for the Orlando Sentinel. Prior to working there, I had never been to the Sunshine State, and as a native Californian found it to be a strange, hostile environment with dangerous wildlife and extreme weather.

One particular quirk I recall was the preponderance of billboards for "pain clinics" as I drove throughout the state, especially in south Florida. These were essentially places where opioid medications could be obtained relatively easily.

But interestingly, much of the news coverage around the growing opioid epidemic seems largely focused on heroin users. Recently, the Palm Beach Post decided to profile all 216 people who died of an opioid overdose in Palm Beach County last year. Titled "Heroin: Killer of a Generation," the "stark display of photos of the dead, accompanied by brief profiles, effectively served The Post's goal — drawing attention to the magnitude of crisis in a way statistics could not, while bringing addiction out of the shadows," wrote Susannah Nesmith in a Columbia Journalism Review write-up about The Post series.

For Lisa Aliferis, a communications officer for the California Health Care Foundation, the report was a "major lost opportunity."

"It's heartbreaking that they call it 'heroin epidemic' because how did so many of these people get started? Likely (it was) a doctor-prescribed opioid," said Aliferis, whose foundation has made addressing opioid abuse a top priority. "Think how differently readers might think about this crisis if the title had been 'Prescription Painkillers: Killer of a Generation.'"

One finding from a preliminary BMSG news coverage analysis of opioid abuse and overdose in Northern California suggests a similar trend, although more research is needed: Only a small number of articles from Shasta and Humboldt counties — where the opioid epidemic is particularly severe — mentioned the role of doctors in addressing the opioid crisis.

While a positive shift in reporting may be emerging — the report found that news about opioid addiction " is routinely framed in the news as a public health issue as well as a criminal justice issue," unlike previous responses to drug use, which were focused mostly on crime — significant gaps remain. "[P]ublic health advocates and medical practitioners are currently absent from the coverage," the report concludes.

Our preliminary findings lay the groundwork for additional research questions. One that stands out is whether news coverage of the opioid epidemic reinforces existing stereotypes of the disease. How do these stereotypes impact prevention efforts and other potential solutions?

One profile in The Post's series highlighted the story of Jessica Rose, a former Florida assistant state attorney with "brimming talent and promise" who, just before 9 a.m. on Dec. 17, 2015, was found dead on the bathroom floor of her West Palm Beach apartment, a white unplugged electric cord in her left hand, a syringe and spoon with heroin residue on the sink above her. She was 32.

As Aliferis mentioned is the case with many heroin users, Rose began by misusing prescription drugs and had been fired from a previous job with the Public Defender's Office in Jacksonville for performance problems related to addiction issues with alcohol and pain pills.

Michael J. Cohen, executive director of a Florida program that offers help to attorneys with substance abuse disorders said existing stereotypes about opioid addiction that focus more on heroin users and less on pain pill addiction just makes the problem worse.

"The stigma is there. The shame is there. Part of that [is] because people's pictures of an opiate addict is somebody with a needle in their arm, not a lawyer who is taking 15 OxyContin," Cohen told The Post. "Your [stereotypical] picture of the junkie under the bridge is not the only picture."

Among the questions the BMSG opioid report poses: What are opportunities for public health and medical professionals to become part of the narrative around opioid abuse and overdose?

Perhaps by taking advantage of these opportunities, public health and medical professionals can help reframe the conversation to include the problem of over-prescribed pain medications and help address the stigma and shame that in large part has helped fuel this silent epidemic.

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