Confronting stigma in substance use, recovery and harm reduction

Understanding stigma as a barrier to support and the importance of boosting awareness around overdose-related injury

People in recovery and people active in substance use have each encountered barriers to supportive recovery services and life-saving measures like harm reduction resources long before COVID-19, though the pandemic has unequivocally heightened the need for supports for those impacted by substance use disorder.

In the last several years, the the need for community-based recovery support services and treatments like those provided by CHD has continued to grow. And, likewise, so has the need to raise awareness around substance use and harm reduction resources as a preventative measure against overdose-related death or injury.

Stigma surrounding substance use remains an enormous obstacle for people who may want to seek support or recovery. An important and effective step in combatting stigma is increasing understanding of substance use disorder and how harm-reduction techniques can help prevent overdose and overdose-related injury or death.

Ingrid Agis is the program director for CHD’s FIRST (Families In Recovery SupporT) Steps Together in Easthampton and Pittsfield, MA, a peer coaching support program for mothers recovering from opioid dependence. With extensive expertise and close connection with those in recovery, Agis explained that there are many ways stigma is perpetuated against people who are active in substance use or are in recovery, and she explained how stigma plays a role in the experience of overdose.

“Stigma exists everywhere, and it’s especially prevalent in the world of recovery,” Agis said. “It can be difficult to address stigma and bias because you see it in so many ways: in the language we use, in how we treat people and in the unconscious thoughts we have when you meet or interact with someone you know who is in recovery.”

Agis explained that stigma is harmful to both those in recovery and those active in substance use in how it impacts social perception. She said it can also negatively impact an individual’s access to harm reduction resources and other important community supports, discouraging them from asking for this kind of help.

“The more we talk about recovery and share experiences with it, the better it is to spread awareness,” Agis said. “I think education on harm reduction and how we can keep ourselves and people around us as safe and informed as possible is really important, both in recovery and in general.”

Tapestry is a CHD partner and a local agency dedicated to providing resources on overdose prevention to people in active substance use and people at high risk of having or seeing an overdose, including Narcan (naloxone) access and training, community education on recognizing, preventing, and reversing an overdose, and referrals to treatment programs and medical care.

Agis affirms that for those in active substance use, harm reduction strategies are what’s going to prevent an overdose, including the ability to recognize the symptoms and provide education on how to use Narcan to reverse an overdose.

Another strategy is to provide a safe space for open dialogue with someone active in substance use and help develop an overdose plan with trusted friends and family. This way, the individual can let a member of their support network know when they’re going to use in the moment; they can leave their door unlocked or ajar to allow for someone to check on them, or try not to use by themselves if they can avoid it. The support person can also have the individual call them afterward or ask the individual if they’d like them to be in the space with them.

Safe spaces for open dialogue can also be crucial for those in recovery to talk about their experiences, which is oftentimes a key aspect.

“Having a support system that’s open minded is oftentimes so important,” Agis said. “When someone is struggling, there’s something truly powerful that happens when they feel comfortable to say ‘I am having a really bad day’ or ‘I am struggling and I need support in this area.’”

In addition to a support network comprising loved ones and recovery coaches, the relationships formed among those in recovery can help create a real sense of community where they feel safe and comfortable to share their experiences and embrace support from others, especially their peers.

“It’s beautiful to see, and a great aspect of the world of recovery,” Agis said. “They’re always willing to be there for one another and help each other along their journeys. Oftentimes it’s not just your recovery coach and your family who support you in recovery, it’s the members you meet and the relationships you make through the group and your experience that help guide you, too.”

While COVID-19 has prevented FIRST Steps Together from holding groups in person and required the program to move to a virtual space, the arrangement has simultaneously created an opportunity to extend the community. Previously, both programs in Easthampton and Pittsfield held their groups separately because they were held in person. Now that they’re virtual, some groups are conducted together, and it’s allowed those served an opportunity to expand their sense of community support.

For more information about CHD’s resources to support recovery, please visit

“The more we talk about recovery and share experiences with it, the better it is to spread awareness. I think education on harm reduction and how we can keep ourselves and people around us as safe and informed as possible is really important, both in recovery and in general.”

– Ingrid Agis, Program Director, FIRST Steps Together