Valerie and Cris Fiore didn’t hesitate when they sat down to write their son’s obituary.

Anthony Fiore, 24, died nearly four years ago from the disease of addiction — one that claims nearly 100 Americans a day.

“We put in that he lost his battle to addiction; we were not ashamed and we didn’t want to hide it,” said Valerie Fiore, of Warrington. “We wanted to let others know it’s out there.”

And while a shortage of beds, widespread availability of cheap and lethal opioids, and a dearth of money and resources to support those in addiction are some of the more obvious barriers in fighting the epidemic, the Fiore family recognized something else.

Stigma is one of the biggest obstacles facing the addiction community, experts agree.

The stigmatizing of addiction has a ripple effect, casting a shadow on nearly every phase of addiction, experts say, from the painstaking step of disclosing the disorder to family to the pressured step of disclosing one’s past in the job application process. Stigma prevents people from getting help, and often prevents family, neighbors and community members from helping, experts say.

“Stigma leads to prejudice, avoidance, rejection and discrimination,” said Dr. Chad Coren, a licensed psychologist and certified addiction treatment consultant who practices in both Doylestown and Washington Crossing.

Coren said stigma doesn’t just influence the addiction community; he said it affects other people battling a variety of conditions associated “with an undesirable trait or behavior.”

“These are folks who are struggling and who don’t fit conventional standards,” Coren said. “People stigmatize because it helps them to maintain distance from something they don’t understand well or express fear; they do it because it helps them feel superior to someone behaving in an unconventional way to express disapproval and feel themselves safer.”

New Jersey residents Anne Gutos, of Moorestown, and Suzanne Harrison, of Evesham, made a choice not to hide after their brother King William Shaffer died of an overdose on Oct. 29, 2016.

Instead of trying to conceal that Shaffer battled with an addiction to prescription opioids and eventually heroin, the sisters decided to use his story to help others like him through their organization, King’s Crusade.

Gutos said she sees firsthand how stigma affects those struggling with addiction and the people around them.

“It shames them into hiding,” she said. “It stops the healing.”

That feeling is fueling the epidemic because people needing help are afraid to seek it and “afraid that the person in front of them is judging them,” Coren said. “People fail to seek treatment. I hear: ‘I walked into my doctor’s office and when I told him (about addiction), the tone changes.’”

Coren said people in active addiction will lie, cheat, deceive, distort and omit information — “things you never thought to do in a million years.”

Those types of behaviors can be difficult for others to set aside.

Michael Sarubbi, of Cherry Hill, New Jersey, and a co-founder of NJTIP, a nonprofit that began in Riverside, New Jersey, said as someone in long-term recovery, he’s dealt with the stigma for years. He doesn’t think it’ll ever go away.


Sarubbi said he still gets “side eyes” from family, friends and co-workers, even after more than a decade in recovery. Still, he said he’s learned to accept.

“Some people think that I’m not a good person and I have no willpower and can’t just say no and I can’t just stop. Well that’s just their issue, not mine,” he said.

Gutos said she doesn’t understand why people continue to stigmatize those in recovery, describing them as “some of the strongest people on Earth.”

Aiming to combat stigma, PECO employee Mike Foley, of Hatboro, and three of his colleagues formed a group, Stomp the Stigma, to let other co-workers know that they don’t have to fight their addiction battles alone or be ashamed of their struggles.

“Co-workers know who I am and what I’ve been through,” said Foley, who is in recovery from a drug addiction. “We want to speak out and help others who might be going through it and are afraid to speak out.

“Hearing someone speak on it might give them the courage to start talking about it so we can direct them to support, get them into rehabs or help family members going through it find help and work.”

Coren said stigma is prevalent in all corners of our communities and even in the therapeutic community, with some doctors refusing to treat people suffering in addiction.


“They say they won’t work with people until they are off all substances,” he said. “That’s like saying, ‘I won’t help you until you’re better.’”

The general public typically doesn’t understand that someone suffering from addiction reacts to drugs like they are a “biological imperative,” like eating and drinking water, Coren said.

“They think if you just tried a little harder, you wouldn’t be in this condition. It doesn’t take into account the neurological perspective of what might be going on. It’s hard to talk about willpower when every cell in your body is screaming at you to use a drug.

“So when people go into withdrawal, they do things they never thought of doing before.”

Daniel Rosenberg, a defense attorney in Mount Holly, New Jersey, said he sees how the stigmatization of addiction has impacted his clients. Rosenberg, principal founder of Daniel Rosenberg and Associates, specializes in representing clients who are battling with addiction and have committed crimes to feed it.

“The stigma piece is always hard, it’s always hard with every addict, everyone who’s struggling because there’s a number of reasons,” he said, “but you have to admit you have a problem or some sort of weakness and that’s an unfortunate part.”

As the heroin and opioid epidemic grows in reach, from the suburbs to rural areas to the cities and to people of all income levels, Rosenberg believes the stigma is starting to recede.


“Now it’s doctors, lawyers, children, inner cities, high-end communities — the fact is that there is a stigma that’s still there, (but) it’s becoming less and less and that’s something I’m grateful for,” he said. “More and more people are touched and that creates more positive change.”

Despite the forward progress, Rosenberg, who also helped create the nonprofit A.J. Butz Foundation in honor of his brother-in-law who passed away at 21 from a heroin overdose, said he still sees people struggling to admit to their addiction.

“It’s still extremely difficult for anyone to come forward because not only are you saying that you are doing something wrong, but you’ve got a problem that you can’t control,” he said.

People who are in recovery are always aware they are under suspicion, experts say.

“You don’t realize how stigmatizing it is until you told someone about your addiction, and you’re getting looks, being double checked on things, and people are constantly monitoring you,” Coren said. “You could be marginalized at work or passed over for raises.”

Much of battling stigma is encouraging equality between physical and mental health illnesses.

“We don’t stigmatize a person for the way they eat that can cause hypertension,” said Coren, adding that many other illnesses are triggered by behavior.


Educating people on addiction as a disease is needed to de-stigmatize the illness and those suffering from it.

However, educational opportunities are sometimes thwarted by stigma, said Joseph Conlin, a coordinator at Prevention Plus of Burlington County in New Jersey.

Often times, his organization, which works to prevent drug and alcohol use in children, is not invited to speak at schools, churches and other events because people fear engaging in a discussion about addiction indicates drug abuse is happening in their community, Conlin said.

“We have difficulty getting into places to do presentations because they don’t want their congregation or their school to admit there’s a problem,” Conlin said. “So it’s a stigma around the fact that, ‘Well, if you’re coming to talk about this stuff, we don’t want people to think I have that here.’ ”

Rosenberg said his organization and others like it can help combat the stigma by talking about addiction and phrasing it in a way more people can accept and understand. Sometimes, he said, that’s as simple as saying it’s an opioid addiction rather than a heroin one. Other times, he continued, sharing personal stories with people who don’t understand addiction can help them grasp it better.

“As a defense attorney, I’m representing individuals with opioid addiction and I share, not names or any personal information, but the type of individuals I represent.

?(They) are everything from athletes to stereotypical drug addicts from bad neighborhoods and areas. I represented an individual who’s 50 years old, who started using when he was 48,” he said. “And sharing that and putting it out there, helps (convey) to everyone that this is a reality we have to deal with.”


The disease of addiction even faces stigma in the nation’s capital.

While Congressman Brian Fitzpatrick, of Middletown, is working to get more funding for schools to create programs that would alert students to the dangers of opioids and addiction, he and others face obstacles when rallying funding for the crisis, adding that “stigma is ground zero for this whole thing.”

“It is a medical condition, not a moral failing,” he said.