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Marcie Hopkins, University of Utah Health
Addiction is More Common Than You Think: Let's Eliminate the Stigma and Break the Silence
Addiction specialist psychiatrist Beth Howell addresses the stigma and silence of substance abuse in health professions. If you or someone you know is struggling, there’s a global community of anonymized support.

deal with a lot of inherently traumatic things in medicine every day. We see people die or get terrible injuries. We see people who have lost control of their lives. We convince ourselves that it is normal. But if we could look at our lives from Mars, we’d realize these experiences aren’t normal at all.  

We all deal with disruption and trauma in different ways. Some people might drink, some people become obsessive compulsive, and others start stealing drugs from hospital carts. Our bodies become reliant on these substances to relieve our stress.  

During my 30 years as an addiction expert, I’ve watched the health care system ignore and minimize the impact of trauma on employees’ mental wellness. The added stress of Covid-19 has led to increased rates of burnout, suicide, and substance addiction among health care workers. We can open the discussion and eliminate the stigma surrounding addiction.  

The story behind stigma and silence  

Most of us have witnessed addiction in one form or another. Some people who choose medicine as a career come from families that battled addiction. In many cases, people experience an unconscious drive to help where they’ve struggled themselves.  

Addiction costs us our dignity and control. In medicine, we think we're in control of everything, because a lot of the time we do have to be in control. If I’m the surgeon cutting open somebody’s chest, I have a lot of responsibility and power.  

That power and invincibility can be seductive. It’s also misleading. Even though we're just as vulnerable as everybody else, we believe we’re untouchable because of what we do. That sense of invincibility puts us in danger. We think, "I can try fentanyl because I understand all the pharmacology about fentanyl. I can't get addicted because I understand it." But even endocrinologists can become diabetic. 

All the weird, intimate and invasive things we do daily in medicine are a routine part of our job. We don’t talk about these traumatic events, because they’re considered normal. We maintain our silence, because that’s what we’re taught. We accept more power, because it’s our job. We turn to drugs or alcohol, because we can’t cope with the stress of that control.  

"Addiction costs us our dignity and control. In medicine, we think we're in control of everything, because a lot of the time we do have to be in control."

Breaking the silence 

Often, people don’t seek treatment for addiction. Addiction is an illness where a person thinks they should be able to control it, because it involves physically putting something in your body. You think, “I should be able to not do that,” but because your brain chemistry has been altered, you can’t stop.  

Even if you realize you have a problem, you fear that admitting it might cost you the respect of coworkers, your medical license, and maybe even your family.  

The hardest part is giving up the notion that you’re in control. Admitting that we need help makes us feel exposed and weak. Recognizing that you can’t control this on your own will be the biggest step you take.  

The truth is, addiction is common 

I can't tell you how many times people—especially professionals—have said to me, "I must be the only doctor on the planet who's done this. I’m the worst person in the world." Everyone thinks they’re the first and the worst, which fosters this terrible isolation of terminal uniqueness. 

Silence traps you and makes you hide your shame and guilt. But you’re not alone. 

Connecting with other professionals in addiction recovery may seem daunting, but one of the plus sides of the pandemic has been the virtual accessibility of recovery groups. I have a friend in California who’s home group is in London. You don’t have to go anywhere to find a meeting and get what you need, although you might miss out on the hugs and bad coffee. Anonymous or otherwise, find a safe space to share your story.  


Elizabeth Howell

Addiction Psychiatrist, Huntsman Mental Health Institute, University of Utah Health

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