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Does stigma matter when it comes to addiction and the opioid epidemic? In a word: yes. Stigma is the wall of shame … you can’t go over it; you can’t go through it; and somehow, it appears around it. Stigma is one of the major barriers in accessing treatment. Why? When one finally admits they have a sub abuse prob, the shame and judgment is like drowning in a pool of dark, thick quicksand. Admitting, that there is a problem with mood altering substances, is so full of shame, embarrassment, and self-defeating, it opens one up to judgment by others. It’s never kind. Historically, we do nothing, we say nothing, and hope it gets better. It never does … not on its own. How do we start the conversation and cut through the barrier of shame? It starts with three of the hardest words the addict will ever say: I need help. When you talk about addiction, the conversation should be as straightforward as if you talk about diabetes or a heart attack. 1 Addiction is a medical condition that effects the brain and changes a person’s behavior. It’s not a moral failing. I’ll say it again: it’s not a moral failing. With this conversation, you open the door to reducing the stigma that holds thousands back from reaching out.