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Shame & Substance Use

Shame. To varying degrees, it is one of the worst feelings we human beings can experience. It is a proven simultaneous negative and positive psychological motivator. Like most of our feelings it has a socio-biological and evolutionary purpose–according to a 2018 article from University of California-Santa Barbara, “shame -- like pain -- evolved as a defense… ‘The function of pain is to prevent us from damaging our own tissue… The function of shame is to prevent us from damaging our social relationships, or to motivate us to repair them if we do.’"

Unfortunately, the same feeling that saved us from being banished from our tribe or clan 200,000 years ago, prevents us from having meaningful conversations about alcohol & drug abuse within our families and, far more broadly, within American society. The stigma and subsequent shame cast by the words “alcohol” or “drugs” coupled with the word “abuse,” kills people in America. We can mitigate the shame; diminish the stigma, and ultimately save lives by just speaking about drugs, alcohol and their abuse.

According to a Pew Research Center study, 46% or nearly half of all American homes have at least one family member, friend or neighbor who is actively addicted to alcohol and/or drugs. That statistic is startling. Half. Half of American homes–numerically speaking, 151.8 million people–are affected by active addiction.

If we take the statistic that nearly half of American homes have a friend or family member in active addiction and throw in that, according to the CDC, the estimated combined annual death toll of excessive drinking and drug overdoses is close to 250,000 people000 we are able to conclude that silence is killing Americans. The way data is collected and extrapolated by the agencies and organizations responsible for compiling it, makes it difficult to state this with absolute certainty but, excessive drinking and drug overdoses are the third or fourth leading cause of death of people 15 to 45. Many of these deaths are preventable through appropriate discourse; so, let’s start talking about it!

Parents and guardians can have prevention and harm reduction conversations at home with their children. More than talking, listening to kids is important. Statistically speaking, the most consistent, leading preventive measure in a child’s life is a supportive, non-judgemental adult. HealthPark Pediatrics of Raleigh, NC has the following suggestions for talking to kids about excessive drug and alcohol use and addiction:

  1. Keep it Age-Appropriate

  2. Be Clear About Rules and Reasons

  3. Lay Down the Law

  4. Talk About Immediate Consequences (Not Just Punishment)

  5. Mention How Expensive a Substance Habit Is

  6. Explain Addiction

  7. Emphasize Responsibility in Young Adults

  8. Don't Stop Talking

For more information on talking to children, adolescents and young adults about drug and alcohol use please visit

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