And then share screen. Hi, everyone. So my name is Madison Elliott. I work with student services at Talbot County Public Schools, and I have here Beth Williams, who normally does the parent monthly parent webinars with me. Sorry, I'm trying to get my laptop straight here. Apologize for the little bit of being late one of those days. But thank you guys for coming out and attending my webinar. Today we're going to be talking about stigma and substance use disorder. Normally, how I like to start these webinars now is from my end, just talking about what I'm doing at the schools every month with the kids. So I wanted to just give those updates. I do have another vaping update, too, I want to share, but first, we'll start with what I'm doing in the school's updates. So I'm going to just do the slideshow at that. So with the topic is purple student club kids. So at some of the middle high schools, we set up a table and the kids were able to educate their peers on tobacco, nicotine. They all signed a vape free pledge. They all got some cool freebies. You can see the picture over here. That went really well. There was a lot, I mean, a lot of kids came up to the table and got that education. So that went really well. Again, some of the club kids worked on, so you can see the posters were supposed to be for Halloween, but because I only get lunchtime with the kids to work on this stuff, time is limited. So it took until a couple weeks ago for the kids to finish their red ribbon Halloween project. So I wanted to share some of those pictures with you. You got like hocus pocus. Drugs aren't your focus. You can still escape the vape. Hugs, not drugs. There's actually a ton of posters and we're going to get them all hung up across the schools. But I wanted to share with you with the pictures that I got with the kids. They worked really hard, hard on these projects, and they're really proud of themselves. So we're going to get them hung up and show them off and show their peers what a great job they did. And then lastly, the past couple months, like October, November, um, the kids have been learning about, you know, common myths and facts about vaping and just kind of taught talking about, you know, what can you guys do? What's another go to or hobby or coping skill you can use instead of going right to, right to vaping or alcohol? Pretty much. So they got these cool little baggies with that on that with, um, cool information. And then this paper here was, um, one of the pieces of information they got to look at. Okay, so next thing there is another vaping update, which is this was really kind of, I don't know how to feel about it yet, but they're called caffeine vapes and they're not FDA approved. But so we found out about caffe vapes through actually a parent of a kind of local parent whose child, they found one of these in their child's bedroom. That's how we found out about what these caffeine vapes are. And so basically they're not. I guess how these crazy companies are going about this is there's no drugs, drugs in the vapes. It's caffeine, vitamin B, twelve melatonin, there's essential oils, it's. I mean, I, even the FDA thinks, obviously this is not okay to inhale into your body, to consume in your body. But I guess that's what these vaping companies have come up with as a way to keep getting our kids and adolescents addicted to this crap. The FDE also says that, um, so it hasn't been FDA approved, but these companies are making them, um, have unproven health claims for anyone using their products. Um, also meaning that like they say there's caffeine in them, but it hasn't been proven that, that it's caffeine in them. So nothing's really been proven on what exactly is in it yet. There's still research going on. Um, but they have found, like I said, like melatonin B, twelve green tea extract milk thrust essential oils. And it's also one of the online companies that are selling these vapes that are making it more easily accessible for kids to buy online. They're also selling this type of caffeine drug product through like gummy softgels and tablets. So you can also get them and like, they look like you're getting drugs sent to you again in the mail. So, yeah, pretty, pretty bad. Yeah. So we're keeping an eye on our end to see if we see this over in our schools. But yeah, that's, I guess that's going to be eventually. The new popular thing now is kids are going to try to use it as, oh, it's just caffeine, it's just a vitamin, it's just melatonin to help me calm down or help me sleep better. But really we all thinking that it's, you know, it's drugs or it's something really unhealthy that you're putting into your bodies. So just wanted to give you guys an update to keep an eye out on. Like, these are more. You can tell more of what the caffeine tapes look like just because they don't look exactly like the typical faith that you find. They have the symbols, so they have like a moon symbol for the melatonin one. They have a lightning bolt for like the caffeine or energy ones. And they have a little plus symbol for the vitamin B. Twelve ones. And they're normally like brighter colored. I guess they kind of look like a, like jeweling devices or they have like what that views. What that views jewel thing has like the top piece of it, but they still look different to me than the typical like vaping products. So. Yep, just something to look out for and what we're looking out for in our end. So really wanted to share that with you guys. All the schools are aware to look out for this, so. Okay. Also, any questions, answers, comments before being any further, you can answer those in the Q and A or the chat at the top. I'll try to look at those at the end because it's a little hard for me to see questions and stuff when I'm on the full screen, but we'll be happy to answer any or all at the end. I'm going to pass it over to Beth to start this social stigma piece. Hi, everybody, and thank you so much for being here. And thanks again to Madison for the fantastic job she's doing in the schools. For all of us, keeping us informed and working with the youth so closely, we're fortunate to have her. What struck me with just the update that she gave is it's always concerning when you're mixing caffeine, which is a stimulant, with something like melatonin, which is acting as a calming. And we have to think about what are the long term effects of a blood pressure or heart rate and those kind of things when we're mixing two drugs of different types. So that's what came clear to me and I'm glad to have this information today. I always enjoy her updates. We're going to talk about stigma today, and you know what that means, what it is, how it affects folks, how it affects all of us. So again, we're glad that you're here and we'll get started. Okay, so what is stigma generally? Stigma is negative thoughts and feelings about oneself that result from identifying with a stigmatized. Negative thoughts and feelings about oneself that result from identifying with a stigmatized group is self stigma. Stigma. Underneath here, sociologists in the 1963 defined stigma as the negative attribute, signaling that one is flawed or condemned, leading to rejection and avoidance by others. So people can stigmatize themselves because they feel a lot of shame for their illness. People in society as a whole can stigmatize or stereotype us, specific group or many groups. So it's propagated or spread through our society in many different ways. A lot of it has to do with language. And we're going to focus some on language today through attitudes or opinions that we may have through policies that are carried out, you know, through federal, state, or local programs or policies or attitudes, access or coverage, and finally demonstrated versus via behaviors. So forms of stigma, we've all heard of these. We all, I'm sure I will tell, include myself. We all, sometimes, without thinking about it, may have thoughts and say, wait a minute, why am I thinking that? Because we're so surrounded in our culture right now with a lot of negative stereotypes, myths, a lot of prejudice that's been rising in our culture. It can come across in terms of disapproval of what a specific type of group, you know, person in that group is doing. Discrimination, fear, shame, and distrust. Okay, so those are some forms of stigma. So what influences stigma? Well, a lot of it has to do with blame. You know, we're human beings. We don't like to blame ourselves for things often. So, you know, folks may blame other people for, you know, jobs or, you know, what's happening in our culture or crime or whatever. We like to have someone else to kind of blame there. You know, maybe sometimes blaming kind of takes the attention off of the rest of us. Stereotypes. We all have these preconceived or we've been exposed to preconceived notions of, you know, this type of person does these things, or we may have firsthand knowledge. One bad experience with someone who's different from us in some way could really change what our attitude is. We could generalize that to the whole group, the media, of course, you know, we see this all the time. Media stories are all about, you know, crime, about mental health, about drug addiction, about, you know, all of the homelessness, immigration. We see all of these media stories that help form or at least inform us and may in some of us turn to, you know, that stereotyping that can happen. Contact and experience again, you know, what's been our experiences with people different from us in terms of race, ethnicity, culture, religion, politics, all of that. So we may then turn that into stigmatizing that particular group of people. I had to add in here to criminalization of addiction, and I'll add also mental health. There's an adoption of tough on crime rhetoric by politicians and lawmakers. Wants to be that person who's going to stop crime. He's going to put people away, lock them up, throw away the key. And that happens very often with people who are addicted. They may have committed a crime, but they may be going to jail and not getting the help that they need. That could stop them from further doing crime. As an example, there's an increased labeling of drug users as criminals. Yes, certainly there are people in our society who distribute drugs, who manufacture drugs, who market drugs in a way that it's appealing to young people. Those, yes, that's a criminal. We can all agree that's criminal. But someone who is addicted to a specific substance, basically that's a health issue that probably leads to the criminality. So we're not really getting to the root of that. We tend to focus on punishment rather than health. When something threatens us as a society, we want to just kind of not have to think about it anymore and, you know, give that person a punishment of some kind. Disproportionately impacting communities of color. The criminalization of addiction. A really good example of this is crack cocaine versus regular cocaine. Years ago, that was an issue because people who were using regular cocaine, you know, powdered cocaine on the party scene or, you know, were not generally sent to jail or were sent for long, for shorter terms, im sorry. Than people who were using crack cocaine. And we know crack cocaine was very prevalent in some of the urban communities. And so folks who were using crack cocaine have gotten sentences ten times or more longer than people who were using powdered cocaine. The more elite use, and that goes for mental health challenges as well. How many times do we see a crime occur on tv and immediately we will hear all the talking heads talking about, well, that person was mentally ill. And we know by research that only 4% of people, 4% of violent crimes are committed by people who are struggling with mental health challenges. So 4% of all those crimes represent someone who is considered mentally ill. All the rest of them are not. Okay, so effects and sources of stigma. So who can be affected? Obviously the individual with a substance use disorder, family or caregivers and addiction professionals. And we're going to talk more about each of those in a moment. Where does it originate commonly the healthcare system. Very often. We do know that physicians receive approximately 2 hours of addictions education in all of their medical school training. So sometimes there's not always a good understanding of addiction and what it really is. Pharmacies, you know, people a pharmacist may question someone that's presenting a prescription for a painkiller, say, if they look a certain way or, you know, are acting a certain way. Criminal justice system. And I'm not throwing shade at our criminal justice system, especially police, because our police are the first responders. They see this all the time. And we have really good police officers in this county. We're very fortunate and very blessed, but the system as a whole, you know, people of certain groups get sentenced for longer periods of time, get harsher sentences, maybe looked at by a jury in a different way. So, you know, this is out there. We know it. We all can feel it and see it regularly that, you know, sometimes things occur in a small setting, but it can spread. So sorry for the hoarseness here. What are the types of stigma enacted or experienced? Stigma, which might be someone who is directly encountering discrimination or rejection. Public stigma, endorsing of the public of a prejudice against a specific group, which could manifest in discrimination toward individuals in that group. I'll give an example. I know somebody who is struggling with a mental health issue, but is afraid to get treatment because they're afraid it will go on their record and they won't be able to get a job. And that, in some cases, is, you know, is a reality. So perceived stigma is a belief that members of a group have the belief that members of the stigmatized group have about the prevalence of stigmatizing attitudes. So perhaps in certain areas, people are not as stigmatized as in other areas or other regions or other situations. But, you know, people sometimes feel like they're on alert for it, and they may perceive it as being worse than it is or maybe not being as bad as it is. And self stigma is the negative thoughts and feelings emerging from a person who identifies with a stigmatized group. And these feelings can include shame, negative, self evaluative thoughts, and fear. A lot of times, people will fear if they're in a group or a social setting and they're feeling stigmatized. They're not sure what may happen because of that. As you all know, anyone who struggles with substance use disorder, shame is the primary emotion that is felt by the families, by the individual. There's a lot of shame involved in this behavior. Same with mental health challenges. There's a lot of shame about it, a lot of secrecy. So across diseases, individual stigma. I know this is a lot of information, but it just, I think, will give us all a much better understanding of what we can do. Individual stigma can generate a lot of fear and guilt. They may not be so willing to be open to family, or to physicians, or to counselors, or to friends. It creates isolation in the individual. So they may, and we'll talk a little more about that in a few minutes, but they may just isolate themselves from people that potentially could be a support system for them. And it may be difficult for them to find a community or a setting or an agency that can help them manage their disease. In terms of recovery, we all know that the earlier something is diagnosed, whether it's a substance use disorder or a mental health challenge, the earlier the diagnosis, the earlier treatment can be started. Outcome just improves tremendously. The average time in the mental health world, which is part of behavioral health, of which substance use disorder is a piece, they're all kind of one field now. There's a ten year difference in the mental health field between when someone is officially diagnosed and when they finally get treatment. The average is ten years of waiting for treatment and help. And we certainly don't need more stigmatizing on top of that when it's already such a challenge for folks to get help. It's difficult. It can affect someone's management and adherence to treatment. Again, there's that secrecy that comes around that I don't want people to know that I'm addicted or suffering, struggling with other mental health challenges, increased complications in life in general, and early death. We know, again, if folks don't get treatment eventually from an addiction, you're going to end up in jail or dead, is basically the saying that's always used. And it sounds harsh, but addiction is a progressive disease. If it's not treated, it will progress to fatality. And then in healthcare system, people who are stigmatized often lack access to the healthcare and treatment that they need. They feel stigmatized when they see a healthcare professional. At times there are insurance barriers. Up until recently, we didn't have insurance coverage for a lot of substance use disorders, and even some insurance companies probably still don't, or it's not sufficient coverage. The healthcare system's openness to treat individuals with the disease. And again, this is not throwing shade at that particular system. We all know wonderful healthcare practitioners who work very well. We're blessed again in this county. But sometimes systems as a whole, there's stigma. Not necessarily every individual in that system, but a person may go to a physician who does stereotype substance use a certain way, and that can taint then their whole opinion of the healthcare system. I will say systems in our society have also been doing quite a bit of these, what do you call them? Like these seminars on not stigmatizing, on cultural sensitivity, on gender and sexual sensitivity, those kind of things. So things are changing, thank goodness for us. And also, stigma can affect funding and other activities to study these exact problems. So I put this in here. I know we're talking about substance use disorder, but I found this really interesting. There is stigmatizing of just disease in general, it appears. I was not aware of it, I guess, or not as aware, but when people have type one or type two diabetes, they experience stigma. People perceive. 72% of people in some studies, perceived that type one or type two diabetes are a failure of personal responsibility. They're seen as a burden on the healthcare system and as that person having a character flaw. So all this negativity, of course, is going to affect the way people who do have diabetes view their disease and how they approach their management. So, again, we may not really. We can say, this is terrible. How can you be stigmatized through an illness? But substance use disorder is a chronic, progressive disease, and the organ that's affected is the brain. Diabetes, the organ is the pancreas or other diseases. It's other organs. So, basically, education in terms of educating ourselves, helping to be more aware, can change misconceptions about diabetes from not understanding the differences between type one and type two, from thinking it should be easy to just, you know, just lose some weight or just go on medication or just don't eat sugar and, you know, why is it that hard, you know, or that individuals should be blamed for having the disease? And this, again, I should have made it clear, is about type two diabetes. Type one is, people are born with that type. Obviously, type two diabetes is something that is acquired over time. But again, we don't know, you know, what the family history is. We don't know that person's makeup in their body, how their system works, etcetera. So, you know, it's just, you know, we're really stereotyping people with disease. Okay, we kind of went over this a little bit earlier. I don't know. This is the same slide that was earlier, but just as a review, people with substance use disorder experience in many aspects of life. Obviously, potentially, the justice system, healthcare system may be at work if they can't get a job because of their drug history. Housing, I think public housing, you can't have any experience with substance use at all. I think if you've had any arrests or anything, you can't get housing often. Education, I'm not sure I know from personal experience in our county, our education system does a very good job in trying to do early intervention, education, social support, peer support. But you know, and overall, in places, you know, other places, people are not that fortunate and they may, they may experience stigma in the educational system, policies, you know, the criminalization of substance use, substance use disorder, clients or patients, you know, to be jailed instead of getting help is an example of a policy, religions, social, you know, all of these areas can be impacted by people. People feel impacted in these areas by stigmatizing or stereotyping. So again, with self stigmatization, the person may experience decreased psychological functioning, quality of life, reduced social support, increased anxiety, depression, guilt, shame and hopelessness, decreased self esteem, internalization of negative stereotypes and negative attitudes. So how does a person cope? Typically, what we see, if you are a substance user or someone who has substance use disorder, if you experience this enough where you feel like people are judging, people are looking down, people are not wanting to help or wanting to stay away or want you to go to jail. Continued. You may just say, what the heck, I'm just going to continue to use because it helps me forget things or forget my stress or reduces the shame that I have over this disorder. They may deny and distance themselves, go into denial or distance from social functions, including meetings like support group meetings, reduced functioning at work. It kind of is that, what do you call it? Self fulfilling prophecy where if people feel labeled in a certain way, you go through that enough, you're just going to feel so pushed down and you're going to just lose hope. You're going to feel, what the heck? Why am I trying so hard? Effects on relationships, including sponsors, like an AA sponsor or a peer support. People may pull back from that, just disengage altogether in social connection or even to go as far as decreasing their involvement or non adherence to treatment regimens. I'm not going to go to that doctor if I feel like he's looking down on me. I'm not going to go to that pharmacist if I feel they're, you know, questioning whether I need this prescription. These are all the feelings that someone may feel or try to cope with feeling stigmatized, something positive that could occur. And again, this would involve having them still be in treatment and working on ways to cope positively, maybe self acceptance. It could even be a motivator for trying to have other good coping strategies and stay on track in their recovery. Okay, there's something called family and affiliate stigma, and this involves people. If there is a someone with substance use disorder in a family, the other people in that family, including the parents, may be blamed for that person's addiction. Again, you know, blaming another person for someone's physiological disease is, you know, really unrealistic. But this is kind of what happens with families. They're often seen as responsible for the onset or setbacks within the progress of that disorder. They may be discredited by the legal system. You know, they go to court, maybe to get custody, but, oh, you have a drug abuser in your house. You know, we're not sure we want to give custody, etcetera, viewed as bad parents, or having made bad or poor parenting decisions. What does this lead to? It leads to people keeping it a secret, or not seeking help, or not reaching out, or not sharing. And as we know, families bear a tremendous burden when they do have someone in their family who struggles with these issues. Okay, I had to put this in since I'm a former addictions professional. I did treatment for a while, provided treatment. Oftentimes people are stigmatized for being in this profession. Often folks that are in this profession act as vocal advocates for treatment and for policy around substance use disorder. You know, it brings a lot of attention to the field, advocating for, you know, better treatment, better insurance coverage, etcetera. Many in the addictions field. Back in the day when I got in, I am not a recovering person, but it was almost all people who had lived experience with substance use or misuse. So there's kind of the perception that has continued that folks in the field rely on their personal experience over the education and training that they've had, or there's insufficient education or training. And now this is. Has behavioral health is considered, has been more professionalized. There are college courses, college degrees. There are certain number of hours every year that have to be completed, and trainings and updates, webinars, et cetera. There has to be some college, I believe in many fields or agencies, you have to have at least a bachelor's degree, if not more, in these particular methods of training and methods of counseling, education on the process of addiction. It is a disease that has a disease process like any other disease does. It has a course of how the disease progresses over time. The field is often underfunded, public and private sector. Sometimes you may go to a mental health clinic, and they may not really have a person who has undergone training in addictions. A few years ago, they combined the field. So it's all under behavioral health now, which is good in terms of resources. You have a lot of mental health folks out there, but often there isn't enough experience or expertise or staff who can really zone in on the substance use part of the treatment and underrepresented, I'm sorry. In medical mental health treatment, lack of in depth training on addiction in those fields, as we know in medical school, there are very few hours dedicated to addiction. Addiction is a degree that needs to be treated medically, so they do not get very many hours of training on it. I'm hoping that that's going to change, but I think there are only less than 1000 providers in our country who are actually certified in addictions medicine. Okay, so how does this affect all of us? What does it mean? Who cares? Stigma. I'm not part of that group, so it's okay. Well, there's something called the looping effect and something happened to my arrows there, but it's supposed to be kind of a phoenix. That's okay. So the shame that is associated with a person feeling stereotyped feeds back into their continued use. So it's kind of like this self fulfilling prophecy. If they say, this is me, this is what it's going to be, and they just can't, they get stuck in this loop. So that can lead to relapse. You know, the person using again, it can lead to their using more or their use changing. Using something different may be decreasing or ceasing their treatment or medical attention. Not just for substance use disorders, but if they have other health disorders, they may not want to get involved with medical treatment. That can all go to legal issues, family impact, job loss and isolation of their support networks. Again, that's all about that individual. What does that mean for us, this general society, as a culture? Well, as a society, we then experience higher rates of addiction and everything that comes with that, how it impacts our communities every day. It affects our schools, it affects every system we have in this country, the health system, our public safety system and legal system, the employment system, etcetera. So this, you know, everything that comes with the use of substances and the stigmatizing of someone who is addicted is going to affect us in our systems as we interact. Are we afraid of crime because we think that people that use commit more crimes? Sometimes that's the case, but not always. Are we afraid of losing our job or are we afraid of someone who has a drug history coming in? So I don't want to hire, that all of these things are going to affect all of us. We can't get away from it. So one of the most substantial reasons that addiction is stigmatized is because most people don't understand it. And it is human nature for all of us to fear what we don't understand. That's part of our, you know, instinctual DNA from back in the stone age. You know, we are afraid of something. We have a fight or flight response when we don't understand something or we're afraid of it or it's different or something we've not experienced before. When people. When it comes to addiction, many people don't see it as the disease that it is. In fact, in polls, still more than 76% of Americans believe substance addiction is nothing more than a moral problem. So, you know, that's not all. That's not in everywhere in the country. It's not, you know, across all lines. But 76% is a lot of people. It's. The majority of people still feel that this is nothing but a poor choice or a moral problem. So what can we do? We can learn more. We can do reading. We can become more educated. We can speak out about stigma. You know, we can try to keep hope alive, because we know, with people that are really struggling with substance use disorder, it is very hard for them to remain hopeful. And so we can, you know, if people we encounter or people that we know, we can just really be encouraging and hopeful. Treat others with dignity. Everyone we know, every human is going through things that we are not aware of. So even if it's not substance use disorder, we all have our issues, our challenges, our pain. So, you know, treating others with dignity, thinking about the whole person and not just this one aspect of this person, oh, that person's an addict, and that taints everything else about them. Well, it doesn't. They still have individuality and should have dignity. And watching our language, which we're going to talk about in a minute, and using social media as a platform, sometimes we have to get on and speak out. If folks we know are, you know, sharing things that aren't true or that are, you know, stigmatizing in some way we can stand up against. That may make it, you know, a little awkward at Christmas dinner, but it is something that we really need to try to do. So words matter. We teach a lot of this in some of the other classes that I teach, someone is not their disease. And so the way that we describe them, we talk about them. We have to be careful of our words because many words are just outdated or very demeaning or stigmatizing. So let's just call it what it is. Addiction or substance use disorder or alcohol use disorder, opioid use disorder, etcetera. That's how they are classified in the DSM, which is the manual that helps psychiatrists and psychologists to diagnose. Those are diagnoses. Use people first language, meaning this is a person with substance use disorder, a person with alcohol use disorder, etcetera. This is a patient. This is not an addict in the hospital. Instead of saying drug problem or drug abuse, say drug use. Substance use, non prescribed use. Don't say abuse, but simply say use. And this is hard because we all slip up. And sometimes the media uses other words or people we know use other words. I'm always checking myself in my language because I use misuse a lot. And in some places it's been stated, you're supposed to try to stay away from that word. So, you know, we try to stay use in general, that's the safest word to use. We want to avoid negative and really awful terms like addict, alcoholic, druggie, user abuser, etcetera. All of this sensationalizes the disease and makes it that much harder for people who have this disease. It is incredibly stigmatizing. We want to try to use phrasing like, this person was addicted, this person has addiction. This person was using drugs. Person first. This is an interesting one, and I was surprised when a few years ago I saw this one. Don't say clean or sober, say in recovery, substance free, well, healthy. Don't say stayed clean, say maintained recovery. And I think it just is because oftentimes people who used were called dirty or called, you know, scum or awful, stuff like this, which, you know, insinuates that this is not a good person, this is an awful person. So clean or sober, you know, are what we're trying to stay away from as well. Talk about recovery management instead of relapse prevention. Relapse prevention is kind of an old, dated term that was used. So we want to talk about the person is managing their recovery, because that can involve so many things. It can be medical, physical, spiritual, social, many aspects of recovery. So relapse prevention, people are going to relapse. People with diabetes on special diets are going to relapse. People who have heart disease are going to relapse and maybe not exercise as much as they should. Relapse is a medical term that's used, but relapse is also a reality. And the relapse rates or the recovery management rates are about the same for substance users than they are for people that have diabetes or asthma. It's right around 50% to 60% of folks being treated for those medical conditions will relapse medically and start the behavior or the use again. So, you know, it's human nature. Recovery from anything is never a straight line. It goes up and down and sideways and circular. And, you know, people are working to manage. And so we want to honor that, that somebody is managing their health in this way. Okay. Okay. We don't want to sensationalize addiction. And I think I said it a few times in here. Again, habits are hard to change, and I'm need to work on that more. We don't want to say something like, suffers from or afflicted with or a victim of or the scourge. This person has a substance use disorder, or they. This person is addicted, or these folks in this group are addicted. It only some sensationalizes and kind of dramatizes things. When we add that other description of somebody is really suffering, somebody is afflicted with, we want to try to empower when we can and encourage people to manage the best that they can. Wait a minute. Had a setback. Instead, we can say they've had a setback. They've resumed recurred. Their use has recurred. They've returned to use or currently using. And again, we want to try to stay away from. We don't want to say that old term, they had a bender or they relapsed or slipped. Again, it feels judgmentally and stigmatizing to someone. Don't say dirty or clean drug screen. Say positive or negative drug screen. I know some of this sounds like a little bit of overkill, and I get that. I hear that. I understand that. But again, we just have to try to use words that are a little kinder in our person first. You know, we don't want to say they're reformed because we know that addiction, like any other disease, is, can recur. It's, you know, a physiological process that happens in the person's body. So, basically, the bottom line is that addiction doesn't define who a person is, but it describes what they have. So their addiction represents only a part of that whole person's life. Defining people exclusively by their addiction diminishes the wholeness of their lives. So we want to focus on that person and then what their challenges are after that, some other things that we can do. Again, many of us are not in the position to do these kind of things, but just in general, we want to normalize substance use disorder. And I know that sounds unusual, and I don't mean normalizing like this is normal behavior, but normalize it how it's happening. Use people that have lived experience that are just humans like the rest of us, but have this particular disorder. We want to increase exposure, and this is more for just general communities or society in general. Increase exposure to or interaction with people with substance use disorder. We all know someone of another culture, another religion, another background of some kind, and it's good for us to be exposed to and learn more about people that are different from us. It broadens our, you know, perspectives, etcetera. So encourage people that we know to evaluate any of our subconscious biases. And again, are, you know, the words that we may still use because we're trying hard to be more sensitive and make information more accessible in terms of professionals, you know, hopefully in, you know, some of the systems that we interact with every day, increasing opportunities for specialized training or certifications, exposure to interactions with people with substance use disorder, incorporating situational training in these professional trainings. You know, what if this happened? Let's role play this. You know, what if our co worker, a co worker came in and was intoxicated? What would we do? Or how would we intervene with someone who was obviously having some mental health challenges or substance use challenges and improving organizational support? A lot of us can't affect those types of things, but we can work on individual or individual attitudes and behaviors and beliefs, examining and working through stigmas we may still attach to addiction. This takes some honesty and some insight, but it's, you know, can really help all of us. Reading reliable literature, educating, and everyday conversation. So if we hear someone says, oh, that person is such an addict, you know, well, you know, maybe I can respond and say, well, that person, you know, I like to look at the whole person, so I look at them as a person with addiction. Sounds kind of know it all. I don't mean it to be that way, but, you know, we can use everyday conversations to support and educate each other. And it's how we communicate with social media. We can vote for candidates who support treatment and recovery. We have some good ones out there right now in Maryland and on the national level that I think can really make some changes in a lot of these health issues. We can involve ourselves with things like recovery month, National Prevention Month, Tropico's purple purple groups. We can involve ourselves in those things and get to know people that may not directly be affected, but may know someone or feel very passionately about the cause, about helping, about changing some of these things. Again, using influence, if we have it, to educate the media and supporting local issues and policies. And we do have, in our county, we have a very large recovery community. We're very fortunate here that folks in recovery feel very supported and they feel engaged with the community. And it's really been a wonderful thing to see evolve in the last few years. So to end today, if we embrace the concept of addiction, is a chronic disease where drugs have disrupted the most fundamental circuits that enable us to do something we take for granted. These drugs are impacting and disrupting and changing physically our abilities to make a decision and follow them through and think things through, because that part of the brain is what's affected in addiction. If we can look at the fact that this disease affects that and it's, you know, we will be able to decrease stigma, not just in the lay public, but the healthcare system among providers and insurers. And this is the director of NIDA, Nora Volkow, who is our new director of the National Institute on Drug Abuse. Does anybody have any questions, comments, if you have any, you can put, you know, you can post them. This is the end of the PowerPoint, but we'd be happy to take questions or comments or feedback. If not, you can always, if you think about anything later, you can always email me. Or we do have one. See, then I always. We had one in there. Let me do, let me do. Stop. Share. Yeah. There we go. There we go. We hope that this has been helpful. This is a subject we haven't talked about before in these webinars. There we go. There we are. Thank you. Thank you for your feedback. Thank you. So glad that you found this helpful again. We always welcome issues or concepts or topics that are in the news, anything that parents are interested in and would like more information about. We always welcome good ideas on webinars. For webinars. Yeah. Like I think we said in the past, if there's anything that you guys want to learn about or touch on or that we can include in any of our other, we can definitely do that for you. Absolutely. So thank you again for attending. Thank you. All right, I hope everybody has a great rest of their afternoon and stay safe this weekend. Thank you. Bye.