Media portrayals unfairly stigmatize patients struggling with addiction

Most Americans learn health news from mainstream media. Journalists should learn to portray addiction without exaggeration.

By Yiying Zhang

“I was living on the streets, and I didn’t believe anyone could help me. Then I got a chance, and here I am in my own apartment with my fiancé and baby,” said Sije in an October interview with the Other Side channel. Just eight months earlier, she had been in active addiction and unhoused. Her story reminds us that behind every statistic is a human being whose life could look different with the right care.

The opioid crisis remains one of the central challenges in American public health. New data from Centers for Disease Control and Prevention show a nearly 24 percent decline in overdose deaths over the past year. But despite the encouraging shift in the numbers, public understanding remains shaped by outdated assumptions. 

That crisis has been sustained in part by American media’s reliance on sensational and dehumanizing narratives, and this pattern of coverage ought to prompt self-reflection within the industry. Newsrooms and journalists have to take responsibility.

According to a study published in the Journal of Health Politics, Policy and Law, Americans get much of their information about public health from the news media, making media coverage of the opioid epidemic a powerful medium for spreading messages that can either reinforce or reduce stigma. Yet many news reports about addiction still rely on fear-driven narratives to draw audiences’ attention. 

One recent example shows the concern clearly. A headline titled “Skin wounds to amputation: U.S. doc highlights the ‘zombifying’ effects of drug Xylazine” reads like something from a horror movie. It is shocking and meant to grab attention. The photos inside the article push that impression further by including close-up images of raw wounds, vacant eyes, and people collapsing on the street.

Xylazine is an animal tranquilizer now found in the illicit drug supply. The story intends to explain the rise of xylazine use and warn readers about its dangers. But the content says little about why people use these substances or how recovery can happen. This neglect creates a story that relies on fear more than understanding. 

“When writing about addiction and drug use, journalists have to strike a balance between warning people of the dangers of drug use,” Lev Facher, a reporter at STAT News, who specializes in covering the US addiction and overdose crisis, said.

However, this balance is often missing in storytellings of the opioid epidemic. And this portrayal fits neatly into a long-standing dehumanizing stereotype of people with substance-use disorder as objects of horror or contempt. “Journalists have to be aware that people they are writing about are still human beings who deserve the same rights as anyone else,” Facher added.

While this kind of extreme imagery is easy to notice, a quieter form of framing shows up in the words used frequently to describe addiction.

Experts at John Hopkins Medicine point out that stigma often begins with something as small as word choice. Words like “user” or “abuser” frame addiction more as a subjective action or personal failure, leading the public to blame addiction for a matter of low willpower. In contrast, calling someone a “patient” places them in the context of healthcare, where treatment is the expected response. 

Addiction is a chronic disease that needs treatments, like all the others. “People don’t expect diabetes to resolve in a week,” says Catherine Livingston said, who is a family physician and assistant professor at Oregon Health and Science University. “But with addiction, they expect people to suddenly ‘get clean’ by simply removing all medications. That is not how chronic illnesses work.”

When people repeatedly encounter terms such as user or abuser, they start to assume that addiction is the result of bad personal choices rather than a medical condition that deserves attention and care.

Even well-trained healthcare providers are not completely shielded from these messages. Media framing can quietly shape their expectations and judgment, just as it shapes those of the general public. This directly affects the quality and accessibility of addiction treatment.

 A review  published in October 2024 in the Journal Drug and Alcohol Dependence Report found that about 20 percent to 51 percent of health providers hold negative attitudes toward people with substance-use disorders. These attitudes are linked to lower rates of treatment referrals and reduced engagement in addiction care. When prejudice replaces compassion, the result is not only social distance but medical neglect.

And the effects do not stop at the level of medical care. Stigma can also turn inward for people who are already struggling. “Stigma around addiction keeps people silent, it keeps people isolated, and it keeps them from getting help they need,” said Livingston. When everyday news stories rely on narratives of failure and moral weakness, those messages become part of how individuals perceive their own experiences.

Research shows that this internalization stigma makes people less confident and less hopeful about seeking treatment. A 2018 review in Substance Abuse and Rehabilitation found that both self-stigma and perceived social stigma increase feeling of shame, isolation, and psychological distress.

These effects can build on each other and create a “why-try” effect, where people start to believe that recovery is not possible for them. The damage of stigma is not only social but also psychological. It isolates people twice – first from society, then from themselves.

But if news coverage can help create stigma, it can also help reduce it. Framing itself can be a form of intervention. A study published in Annual Reviews of Political Science have shown that even small changes in wording can shape how audiences interpret a story. Newsrooms have a responsibility to use words that do not reinforce blame or moral judgement. 

The goal of health writing is always to inform people, not scaring them. “Reporters should use language and visuals that are accurate and neutral, not sensational, ” Facher explained. Graphic images of wounds or collapse may capture attention, but rarely foster understanding. Newsrooms should choose photos that respect the dignity of the people involved and avoid reinforcing the idea that addiction looks only in a horrifying way. 

Coverage must also broaden beyond the most extreme cases. Stories that only portray the burden obscure the role of accessible treatment and attainable recovery. Reporting on housing stability, harm reduction programs, medication-assisted treatment, family support, and individual recovery stories would offer a more accurate and complete picture of the crisis. These stories are not “soft” or “boring”, but understandable and relatable to a broad audience.

To be sure, addiction carries real risks, and journalists cannot ignore the dangers of fentanyl, xylazine, or a contaminated drug supply. The problem is never reporting danger, but reporting it in a way that strips people of humanity. Accurate coverage and humane coverage are on the same page. They are both necessary.

To achieve this ideal balance, newsrooms can adopt style guidelines to standardize writings. A July 2025 report from the U.S. Government Accountability Office noted that preventing drug misuse takes more than accurate facts. Messages need to be clear, empathetic, and credible.

The report outlines a practical blueprint suggesting journalists to understand the audience before choosing a message, select messengers and formats that build credibility, and test whether language and imagery communicate what they intend to. 

In addition to guide by the U.S. Government Accountability Office, international guidelines already provide a practical roadmap for stigma-free reporting. For instance, the Canadian Center on Substance use and Addiction’s Stigma Primer for Journalists advises newsrooms to frame substance-use disorder as health issues, challenge negative stereotypes and biases, choose subjects and story carefully. These recommendations give newsrooms a clear international consensus on covering and reviewing the crisis.

Journalists are uniquely positioned to help the public understand addiction as a public health issue. Many clinicians, policymakers, and community organizations have spent decades studying how language, images, and narratives shape health outcomes. Journalists should draw from that expertise and triple check every single detail they include in the work. Responsible reporting requires more than avoiding stereotypes, but understanding how stigma works and how to avoid reinforcing it.

Stigma is not inevitable; it is an avoidable product of how we talk about it. It is created by the perspectives we choose to tell stories and images we decide to show. If newsrooms take seriously the influence they hold, they can help move people closer to treatment and educate them on a daily basis with a low threshold of entry. Although journalism cannot directly solve the opioid crisis, they can take actions to stop making it worse.