Changing the Stigma Around Addiction Is a Matter of Life and Death, Says Robin Avalos

The cost of stigma surrounding addiction is far greater than most people acknowledge. It reaches beyond individual lives, damaging families, fragmenting communities, and draining critical healthcare and economic resources. Every time addiction is treated as a moral failing instead of a medical condition, the door to early intervention, compassionate care, and recovery closes just a little more. That door closing can cost lives.

Robin Avalos, MMS, PA-C, knows this reality. In fact, she has always been committed to fighting against stigma. This dedication stems from personal and professional experience. The loss of her brother to an overdose, and of her uncle-in-law just weeks after release from prison, made the issue heartbreakingly real. Moreover, as someone who has worked in correctional healthcare, she's witnessed how system failures perpetuate cycles of trauma and addiction.

Hence, Avalos believes that a shift in collective thinking is overdue. "We must stop vilifying those who struggle with addiction and start seeing them as people worthy of support, compassion, and connection," Avalos states. "Changing how we think and talk about addiction is the beginning of saving lives."

It's necessary to understand addiction itself first to understand why the stigma around it is dangerous. Contrary to how it's typically portrayed in media or casual conversation, addiction doesn't begin overnight. It unfolds gradually, sometimes so quietly that neither the person experiencing it nor those around them recognize the warning signs until it has progressed to a critical point.

This slow build is part of what makes stigma so deadly. In the early stages, when intervention can be most effective, many individuals choose to suffer in silence. They're afraid of being labeled, judged, or ostracized by friends, family, or even healthcare professionals. That silence can grow louder until it becomes despair. If left untreated, addiction can spiral into depression, self-harm, and suicidal ideation.

The fear of being seen, especially in the beginning, keeps many people from seeking help. Avalos notes how this fear becomes a barrier even in conversations with loved ones. "People feel hated," she says. "They feel villainized. And if you think the world sees you as less than human, why would you raise your hand for help?" The inability or unwillingness of society to empathize plays a major role. "People struggle to imagine what it's like to walk in someone else's shoes. That lack of empathy is costing lives," she says.

Modern science has made it clear that addiction isn't simply a matter of willpower or poor choices. It physically changes the brain. Prolonged substance use rewires neural circuits, particularly those tied to reward, motivation, and impulse control. The frontal lobe, the part of the brain responsible for rational decision-making, loses its ability to regulate the emotional and instinctive parts of the brain.

That means people battling addiction are often not just dealing with chemical dependence. They're also dealing with a brain that's working against their own best interest. "It's not that they don't want to stop," says Avalos. "It's that the very mechanisms they need to make healthy decisions have been disrupted."

Avalos stresses that this understanding should change how society views and treats people with addiction. Unfortunately, it often doesn't. Despite decades of research proving that addiction is a disease, many still view it as a moral failing. Avalos has seen how damaging that mindset can be. "They do nothing but push people deeper into isolation," she remarks.

Human intervention plays a significant role in this landscape. A strong, aware individual in someone's life can make all the difference. However, Avalos emphasizes that loved ones aren't always the right people to take the lead. While family and friends can recognize early warning signs and initiate difficult conversations, recovery typically requires professional support.

This is especially true for men who are often socialized to internalize their struggles and avoid vulnerability. Avalos has worked with many male patients through consistent, judgment-free telehealth check-ins. "They just needed someone to process things with, to say things out loud. Not to be fixed immediately, just to be heard. And that alone made a huge difference in their outcomes," she shares.

In recent years, telehealth has also emerged as a critical tool in combating the logistical and emotional barriers to care. Individuals can now access treatment from their homes, preserving privacy and reducing the fear of public exposure. "Telemedicine has made a huge impact. I've seen it empower people to seek support when they wouldn't have otherwise. Some patients felt safer talking to me from their cars than walking into a clinic," she states. Platforms now offer addiction-specific services, hotlines, and even regular virtual coaching, expanding access to care.

Overall, Avalos is hopeful. She believes that by removing the stigma and creating safe spaces for people to speak and be heard, the cycle can be broken. "We have to keep people alive," she says. "All we have is the moment in front of us. If we let shame and judgment take over, we lose that moment and we lose people."