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By Sumay Gupta
The opioid epidemic is a threatening issue in the United States, and Alameda County is no exception. By 2022, Alameda County saw over 220 fatal opioid overdoses, nearly a 500% increase from 2017, reflecting a dramatic and alarming escalation of the crisis. Yet, amid the devastating statistics lies a hopeful movement not only to prevent overdose deaths but also to challenge the stigma surrounding opioid use. Local organizations in Alameda County have shifted the conversation over the years from shame to empathy, and from silence to a voice to be heard.
Opioids are considered a class of natural, semi-synthetic, and synthetic drugs used to treat pain. Opioids can be used to treat acute-to-chronic pain and are used to treat different health conditions. The first instance of prescribing opioids in the 1990s involved over-the-counter prescription opioids, which doctors used to prescribe opioid medications to manage and treat moderate-to-severe pain. The rampant increase in deaths could be attributed to high addictiveness and widespread availability of opioids. In 2022, according to the Centers for Disease Control and Prevention (CDC), nearly 108,000 people died from drug overdose, and approximately 82,000 of those deaths involved opioids.
The United States has struggled under this complex, multifaceted public health emergency. Alameda County has not been immune to these challenges as the increase of drugs led to a negative stigma driven by stereotypes about people with opioid use disorders, such as their perceived dangerousness or perceived moral failings. Many of these stigmas were created through laws, misleading messaging, and the overall moral framing of addiction.
Historically, opioid addiction was largely seen as a medical condition for which people sought help from doctors. Addiction was understood as either a personal failing or a medical problem and was treated accordingly.
However, the federal government became more progressive with the crackdowns on narcotic control, leading to Congress passing the Harrison Narcotics Act in 1914 that required narcotic manufacturers, sellers, and distributors to register with the Bureau of Internal Revenue, which became the first law in the US to regulate drugs – essentially, enforcing both users and providers to shift the public perception of addiction to become a crime.
Although the Harrison Act has been replaced by the 1970 Controlled Substances Act, its effects persist today, contributing to the stigma that associates opioid users with danger, deviance, and immorality.
In 1996, Purdue Pharma introduced OxyContin, an opioid that was heavily marketed to be safe and have “low” risk of addiction, quoting statistics on “how less than 1% of patients become addicted” taken from a single paragraph in a 1980 letter to the New England Journal of Medicine, which looked at hospitalized patients only and had no follow-up on long-term addiction risk.
Purdue trained over 5,000 sales reps to tell doctors “that the risk of addiction is extremely small, and how ‘Oxycontin only lasted 12 hours,’ even going as far as to offering free samples, and creating promotional materials that downplayed addiction risk.
This would have major consequences with doctors overprescribing opioids, believing them to be safe and highly versatile for a wide range of pain types. Patients trusted doctors, becoming addicted in the process, and with tighter regulations, patients were forced to turn to heroin and fentanyl.
This crisis would fuel the stigma when the truth emerged in the mid-1990s with the first wave of deaths linked to the use of legal prescription opioids. The public response shifted blame to the users rather than the public corporations, with the blame being split between the label of “victim” or “junkie.”
The OxyContin crisis had devastating effects, with distrust in the medical system and worsening public perception of opioids. Yet even as the public perception of opioids has become increasingly negative over the years, there are a few organizations in Alameda County that are offering hope by working to reduce the stigma associated with opioid use.
In Your Corner is a collaborative initiative led by the Alameda County probation department that aims to reduce stigma and increase awareness around opioids and substance use. They provide key tools and resources, support training, English/Spanish toolkits, stigma-conscious language guidance, digital and print media, outreach material, and community collaboration.
They have created pocket cards listing local resources for housing, mental health, wound care, naloxone, and crisis lines. In Your Corner also provides small group training sessions and community forums, in collaboration with organizations like La Familia and Urban Strategies Council.
These initiatives have helped foster a more compassionate understanding of addiction, reduce shame, and empower community members to seek help and connect with resources without fear of judgment.
Similarly, East Bay Safe Prescribing Coalition, an organization led by the Alameda-Contra Costa Medical Association (ACCMA) and County Health Partners, works to promote safer prescribing practices and reduce the harms associated with opioid use.
This coalition focuses on public education initiatives, including naloxone training. Their goal is to promote safe and appropriate opioid prescribing among clinicians, reduce drug misuse and related harms in the community, expand access to overdose prevention, including naloxone distribution, and support medication-assisted treatment. They encourage health care providers to consider non-opioid alternatives and practice responsible prescribing, acting as a critical bridge between medical providers, public health, and the community.
Through these efforts, the East Bay Safe Prescribing Coalition helps make life-saving tools more accessible and plays a key role in changing the narrative around opioid use and reducing its associated stigma.
Opioid stigmatization matters because it directly harms people who use opioids or suffer from opioid use disorder, making it more difficult for them to find help, care, and a path to recovery. Stigma not only prevents individuals from accessing life-saving options, like medication-assisted treatment, but also makes it harder for health care providers and communities to respond effectively.
The organizations in Alameda County show us that change is possible when we treat addiction with compassion instead of shame. By shifting the conversation from silence to a voice that advocates for understanding and support, we can create a society where recovery is within reach for everyone, and where the alarming trends we face today can become stories of hope, healing, and renewal.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
