IU School of Social Work, Hoosier Uplands partner to eradicate stigma with community series

BEDFORD, Ind.— A new series has successfully shed light on the stigma around substance use in Lawrence County, organizers say.

Three years after Lawrence County’s health department declared a state of emergency following a sharp rise in hepatitis C cases—and a year after county commissioners ended its needle exchange—providing resources for people with substance use disorders has remained a hot-button issue among locals.

IU School of Social Work assistant professor and Lawrence County resident Dr. John Keesler first began planning “From Stigma to Hope” last November with his graduate-level class.

“With faculty support, the experience allowed students to hone their skills in working as members of a team and to collaborate with a community organization to deliver a quality presentation.  Often times, students work on presentations for a course that are delivered to their peers.  This opportunity took students to the next level and was something they engaged in above and beyond their coursework,” Keesler said.

The series, which spanned from April to May in three installments and received backing from the Hoosier Uplands Economic Development Corporation, centered largely around themes of harm reduction—approaches and strategies that reduce the harm caused by substance use—and stigma.

After several collaborative planning meetings with Keesler and students, Hoosier Uplands social worker Ashley Gilstrap said she was pleased to watch the students inspire meaningful community conversations.

“We had 30 minutes to an hour of just questions, and lots of interaction,” Gilstrap said. “Many people shared personal stories about family members who were dealing with an addiction, and were able to ask some hard questions.”

“The students definitely learned that you have to look at issues and solutions in a different way than one would in a more urban setting,” Gilstrap said.

During the 2017-18 academic year, some of Keesler’s students developed a community survey at the request of Sheriff Mike Branham and other stakeholders.  The survey explored citizens’ attitudes and experiences regarding mental health and substance use. Surveys were available both online and in paper with information distributed creatively, stuck in everything from church bulletins to utility bills.  This project was launched in partnership with IU’s Center for Rural Engagement.

“A decent amount [of surveys] were returned, and these fueled our presentations,” Master of Social Work student Kym Blackford said.

Classmate Sean Abraham said a few of the written survey responses he read, like “addicts are sinners,” revealed that stigma – or negative perceptions around substance use disorder – were a significant issue in the community.

Abraham, who is in long-term recovery, used the roundtable discussion following his presentation to explain stigma and share harm reduction techniques with audience members.

He shared a simple step that can make all the difference in addiction-informed care: tweaking our language.

“Consider saying things like ‘maintaining sobriety’ instead of ‘getting clean’, which implies dirtiness, and instead of ‘addict’, say ‘somebody who uses substances,’” Abraham said. “And it’s substance use, not abuse; we’re all people first.”

Abraham also noted that some participants questioned whether buprenorphine (Suboxone) and naloxone (Narcan) actually helped substance users, he said. Others asked if it was possible to overdose on those drugs or suggested the “cold turkey” method.

“[Instant sobriety] doesn’t work for everybody, but it was good to be able to have that constructive conversation where we were both able to learn about the fears on one hand and the successes on the other,” Abraham said.