Imagine the daily reality for people who use substances: they walk into clinics burdened by the fear that saying the wrong thing could impact their care, they share their struggles only to be dismissed, misunderstood, or even ridiculed, and they face a cycle of stigma and diminishing resources that alienates them from friends, family, and even from themselves. At every turn, they encounter judgment instead of understanding, barriers instead of support, punishment instead of treatment. These obstacles aren’t merely physical - they permeate everything - embedded in our language, our facial expressions, our policies, and our cultural attitudes.
Imagine a triangle of disconnect between three groups: 1) individuals who use substances, 2) the professionals who work with them, and 3) society at large.
For individuals using substances, these gaps leads to feelings of judgment and isolation, while professionals, constrained by outdated or incomplete models, may miss the deeper motivations behind substance use. Society, meanwhile, reinforces stigma through stereotypes and policies not only hinder recovery, but it actively pushes people into worse conditions that make substance use worse.
Now, imagine a world where these gaps close - a world where we see the person, not just the substance use or condition. In this world, treatment isn’t a rigid, one-size-fits-all process; it’s personalized, grounded in compassion, and driven by the individual’s own strengths and hopes. It’s a world where friends and family foster recovery, possibility, growth, and empowerment. It's a world where people end up with knowledgable, compassionate professionals instead of prison.
Let's organize the chaos into a framework.
At the center of it all are the people who use substances; but, maybe we know less than we think about why people use substances.
In the next level, we have professionals who study and treat these individuals; but, maybe we know less than we think about how to care for people who use substance use.
Above it all, we have society who set up and reinforce systems consisting of resources and responses; but, maybe we know less than we think about why these systems often make substance use worse.
Notice how the colors blend into each other, reflecting the reality that each layer is interconnected, flowing, and constantly influencing each other.
Now, notice how the layers are embedded, reflecting that to truly help people who use substances, we cannot focus exclusively on any one of them.
Any progress at one level is likely be undermined if we ignore the higher layers.
Thus, it seems that to sustain progress we need to address all the layers.
Let's unfolds these layers into a plan, phases, each building on the last.
Phase I: We must go back to the people and hear what they have to say.
Phase II: We must take this knowledge to develop better strategies to tackle their problems.
Phase III: We must use this knowledge and strategies to change systems of oppression into systems of growth.
So good so far? Let's break this plan down.
Here is where we are at right now. I am working on using the opinions and perspectives of the people to improve our understanding of why people use substances despite the consequences.
Here are some of my Phase I papers.
I introduce a concept called Substance-Induced Emotion Regulation, which suggests that people use substances to change their emotional states to help them do something better (e.g., drinking to be more sociable)
I developed the Enthusiastic Substance Use Attitudes Scale (ESUAS) to capture positive views on substance use benefits, like socializing and relaxation, for a more understanding and less stigmatizing perspective.
I introduce a concept called perceived addiction potential, which is how likely someone thinks they are to develop an addiction. I showed that people’s self-assessed risk aligns with their actual risk factors, challenging the assumption that people underestimate their SUD risk.
Then, I will attempt to shape the public's perception of why people use substances by demonstrating potentially effective treatments that use atypical strategies.
Here are some of my Phase II papers.
I demonstrated that there may be alternative approach to treating cannabis use disorder that do not involve abstinence, such as reducing cravings and use. I also demonstrate that men benefit more from craving reduction and women respond better when addressing depression.
I argued that substance use treatments should incorporate positive psychology, which focuses on enhancing life satisfaction, to address addiction more effectively.
I introduced a new perspective using positive psychology to understand why people turn to substances, suggesting that they may help people fulfill basic needs for happiness, like joy, engagement, and connection.
Finally, I will use all the knowledge and treatment demonstrated in conjunction with the people to support widespread system changes.
Here are some of my Phase III papers.
I found that removing stigmatizing language from self-report measures (like at the doctor's office) didn’t change the tool’s accuracy but did lower participants' stigmatizing beliefs, especially among those without a history of substance use.
I argued that the War on Drugs has biased substance use research to overemphasize harm and ignore potential benefits of substances. I call on researchers to approach research with less bias - exploring risks and benefits.
I analyzed Ohio's cannabis legalization struggle and present five strategies I think lead to successful policy change, which were ongoing advocacy, strong coalitions, empowering grassroots movements, data-driven research, and public education.
There's only one way to find out.
Next year, I will begin interview-based qualitative work related to opioid and cannabis use, in-line with Phase I. I have much more planned that I will report to you all soon.
Thank you for hearing me out 😁 stay tuned!
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