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The Power of Stigma

Addiction stigma plays a key role in tens of thousands of substance use-related deaths each year. Stigma keeps people from seeking treatment, creates social isolation, and prevents the use of life-saving medications.  

  • Stigma can keep people with a substance use disorder from seeking treatment. When people feel judged, they are less likely to talk about their substance use with a family member, friend, or medical professional. 
  • Stigma sometimes restricts resources or continues harmful policies. This can limit a program’s ability to provide the right support when someone asks for help. 
  • Stigma can cause people to feel shame that impacts their long-term mental health.

Types of Stigma

Public Stigma: Public stigma is society's negative attitudes toward a group of people, creating an environment where people feel unwelcomed, judged, and blamed. 

Less than 50% of Americans are willing to have a person in recovery from a substance use disorder marry into their family.

Structural Stigma: Structural stigma includes systems-level discrimination caused by institutional policies and/or dominant cultural norms. 

88% of Americans believe employers should provide opportunities for a person with a substance use disorder to seek treatment and stay employed. 

Self-Stigma: Self-stigma happens when people internalize society’s stereotypes and experience low self-esteem. 

46% of Americans with an opioid use disorder expressed feeling ashamed of themselves. 

Stigma Against MOUD: Medication for opioid use disorder (MOUD) is an effective, clinically proven treatment that helps people in their recovery. People recover differently – one way people recover is with MOUD. 

74% of Americans agree more healthcare providers should offer MOUD. 

On the Campaign Trail

Here and Now 

  • 6,843 Californians died in 2021 from drug related overdoses – a 111 percent increase from 2019.
  • The COVID-19 pandemic increased economic instability and social isolation, while reducing access to harm reduction, treatment, and recovery services. Structural racism and already-existing health inequities worsened the impacts of the pandemic for historically marginalized communities, leading to increased rates of substance use and overdose. Californians need to act now to stop the stigma and heal our communities.

Unshame CA Impact

  • The Unshame CA campaign combines the expertise of local community leaders, the power of digital platforms, and authentic and inspiring stories of people impacted by substance use disorder (SUD) to share a message of hope.  
  • The campaign collects stories that represent Californians’ beautiful and unique diversity and shares them across social platforms to spread the message that SUD is a treatable medical condition and that people with SUD can and do recover.
  • Campaign strategy and content is developed through consultation with community members, ensuring that the campaign is meeting Californians where they are and intently focused on providing the resources and information that meets Californians’ needs.
  • The Unshame CA team works in collaboration with local community leaders and community-based organizations to share these stories of hope and compassion.
  • The campaign provides resources to support all Californians to reduce the stigma around substance use disorder in their communities.

Campaigns Across the Country

  • Pennsylvania’s addiction stigma reduction campaign launched in 2020 
  • Kentucky’s addiction stigma reduction campaign launched in 2022 
  • California’s campaign launched in 2023 

Index Report

  • The Shatterproof Addiction Stigma Index (SASI) is a measurement tool designed to set a baseline measure of substance use stigma. This tool measures public stigma, structural stigma, self-stigma, and stigma against medication for opioid use disorder (MOUD).  
  • Unshame CA uses the SASI to carry out a baseline evaluation of Californians’ beliefs and stigma levels before the campaign and again at the end of the campaign. 
  • By evaluating stigma through the SASI, the Unshame CA team can determine where to focus campaign strategy and can measure the success of the initiative’s impact in reducing stigma at the end of the campaign period.


Unshame California is brought to you by the Department of Healthcare Services (DHCS) in partnership with Shatterproof


Unshame California

Shatterproof is a nonprofit, tax-exempt charitable organization (Tax ID #45-4619712) under Section 501(c)(3) of the U.S. Internal Revenue Code.

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