Reporters urged to use precision and compassion when covering addiction

By Heidi de Marco, California Health Fellowship

Covering addiction requires a delicate balance of accuracy, ethics and empathy, particularly as drug policy and treatment systems shift in political and cultural currents. At a recent HJ25 book talk, Maia Szalavitz, author of Undoing Drugs: How Harm Reduction Is Changing the Future of Drugs and Addiction, and moderator Hannah Furfaro of The Seattle Times urged journalists to challenge outdated narratives and center people's lived experiences in their reporting.

Furfaro opened the conversation by sharing how difficult it was to report on the fentanyl crisis among youth, which she did as an AHCJ Health Performance fellow in 2024. She emphasized how careful, trauma-informed practices are vital to minimizing harm to vulnerable sources.

Szalavitz expanded on these concerns by critiquing systemic failures in addiction treatment and the language used to describe it. "Addiction is compulsive drug use despite negative consequences," she said, noting that it's distinct from physical dependence, a key clarification often missed in reporting. She urged reporters not to conflate the two.

The speakers also criticized terms like "substance abuse" as stigmatizing or misleading. "Abuse implies violence or harm to others," she said. "You're not beating the little cocaine with a whip."

Instead, Szalavitz advocated for precise, destigmatizing language, such as "substance use disorder" and emphasized the importance of distinguishing between mild, moderate and severe cases. Mischaracterizing the spectrum of use can lead to distorted public perceptions and harmful policies, she said.

Szalavitz also addressed the persistent stigma around medication-assisted treatment (MAT), including methadone and buprenorphine. Despite strong evidence that these medications reduce overdose deaths, cultural and institutional biases - especially within 12-step programs - still characterize MAT users as not truly in recovery.

"Unfortunately, Narcotics Anonymous, which is the program specifically for people historically with heroin addiction, says that you are not clean if you are on one of these two medications," she said.

On policy, Szalavitz expressed concern over a return to punitive approaches under figures like Robert F. Kennedy Jr., who has embraced tough love and faith-based recovery models. She warned against coercive, one-size-fits-all treatment programs rooted in outdated ideologies.

"About 70 or 80% of people with addiction have suffered severe childhood trauma," she said. "Putting them in a situation where people are screaming at them as their treatment, it's re-traumatizing."

For reporters, Szalavitz emphasized the importance of pursuing underreported system failures, especially those that expose fraudulent or abusive treatment practices. She also encouraged reporters to ensure stories are grounded in science and compassion.

"If you ask people about the specifics of how they got better - what did work, what didn't work - you'll find a million different stories," she said. "You can get really cool stories that also happen to be uplifting."

Heidi de Marco is a health reporter for KPBS based in San Diego.