Ethical Reporting is the Antidote to Misinformation in the Opioid Epidemic

(NEW YORK) — A quick Google search of “rainbow fentanyl Halloween” generates over 18,400 news results. Most of these hysterical and sensationalized news stories centered around a narrative that Mexican drug cartels were deliberately designing the deadly synthetic opioid fentanyl to look like candy. Even worse, it would likely end up in your child’s Halloween candy. Mothers were terrified. Fox News relished the opportunity to talk about border control. A new urban legend was born. 

The tailspin resulted from an Aug. 30, 2022, press release in which Drug Enforcement Administrator Anne Milgrim warned the public of drug traffickers using this method to “drive addiction amongst kids and young adults.” While the threat of brightly colored fentanyl is imminent, and 12,000 suspected fentanyl pills were seized at LAX disguised in boxes of Sweetarts, Skittles, and Whoppers in late October, fentanyl is a fraction of the opioid epidemic. The current coverage that fentanyl receives is at once overblown, being used to propagate and subsequently spread misinformation that fuels stigma about opioid use, addiction, and recovery in our country rather than address solutions. Misinformation can stem from various sources and is an ethical issue for reporters and the media when discussing the opioid epidemic.  

The American Society of Addiction Medicine classifies addiction as a chronic disease. However, according to research from the patient advocacy group Shatterproof, 75.2% of the public does not believe substance abuse disorder is a chronic illness, and 53.2% attribute substance abuse to bad character. Opioid use is often a matter of life and death, and the stigma and discrimination are evident. While addiction may not be a choice, the language and the way the media describe the disease are. The current media landscape does not accurately portray the complexities of the opioid epidemic and negatively impacts individuals struggling with substance abuse disorder. 

“When we mapped out the nine drivers of the opioid epidemic, seven of them are rooted in stigma,” said Kirsten Seckler, the chief communications officer of Shatterproof. “It all comes back to the fact that there’s so much stigma or misunderstanding, and that misunderstanding leads to misinformation. What needs to happen in the country is education.”

In June 2022, the host of HBO’s “Real Time,” Bill Maher, attributed the “collapse of American society and civilization” to shame and lack of judgment. Maher argued this fact by citing government-sponsored PSAs relating to harm reduction in New York City and San Francisco, encouraging people to use safely and without shame. 

“Shame is part of life. We do this to everything,” Maher said. “Toxic positivity. Everything is positive. Everything is not positive. You should be ashamed that you are using, that might help you to stop.”

Harm reduction, an evidence-based solution for people struggling with substance abuse, has been proven to save lives. Maher’s blatant disregard for science is a perfect example of how the media can lack empathy and further drive stigma regarding opioid use. Journalists and all media must be cognizant of how they approach discussing substance abuse to avoid perpetuating the stigma, which can have fatal consequences, fuel misinformation, or hinder the ability of someone to find accurate information that could save their life. 

On Dec. 14, 2022, Fox News ran a story with the headline, “Florida cop receives three doses of Narcan after overdosing on fentanyl during a traffic stop.” The story preceded another story the day before on the same police officer who was heard “choking and breathless’ after possible exposure to fentanyl.” The article asserted that the officer, who was wearing gloves while handling seized fentanyl at a traffic stop, could have possibly inhaled residue off accompanying seized dollar bills contributing to a suspected overdose. This scenario seems unlikely, mainly because there was no confirmation in the reporting about the actual ingestion of fentanyl, and the officer was expected to recover fully. There was little substance to the piece, and no experts were consulted- especially regarding the claim of the possible inhalation of fentanyl residue requiring three doses of Narcan. Further, the article ultimately was skewed as a scare tactic against fentanyl and ended with a line about felony charges against the individuals involved. Fox News perpetually runs these stories that demonize fentanyl and delineate from the narrative of healing and recovery regarding opioids. 

“The media’s role is to accurately convey what is going on with addiction, and if we accurately convey what is going on in addiction, we know that we can change minds and perceptions about how people view addiction,” said Jonathan JK Stoltman, a researcher and co-founder of Reporting on Addiction, a collective of experts dedicated to improving how the media covers addiction.

“Most people view it as that moral failing, or that personal choice, Bill Maher being one of those people,” he added. “If we’re just making fun of folks and saying, like, ‘well, why don’t you just like put down the crack pipe?’ you know, that’s really stigmatizing and discriminating.” 

According to the United Nations Educational, Scientific, and Cultural Organization handbook, “Journalism, ‘Fake News’ & Disinformation,” “mobilizing and manipulating information” is a tactic that long precedes the ethical standards established in modern journalism today but is amplified through the technology of the 21st century. However, when it comes to something that is already commonly misunderstood, like opioid use, experts say the misunderstanding fuels misinformation, and the misinformation fuels the stigma. It is cyclical. 

“You have to think about the person disseminating the misinformation and their intention. In some instances, it seems clear it’s for political purposes,” Stoltman said. “With the DEA, regarding rainbow fentanyl, at that time, they were working on budgets and funding for the next year. They pushed out this big story about this new boogeyman and how it will be in everyone’s Halloween baskets and destroy the world. It caught like wildfire because it was Halloween, it was targeting kids, and it was fentanyl, which people are really scared of but don’t understand.”

Fentanyl was introduced in the 1960s as a pharmaceutical to treat severe pain but made its way into the American illicit drug market through overprescription by doctors and drug cartels selling counterfeit prescription pills laced with fentanyl, according to the DEA. In 2021, the DEA reported overdose-related deaths reached a record number of 107,622, and two-thirds of those are attributed to fentanyl. Fentanyl receives an overwhelming amount of coverage in the media because people are fearful, and rightfully so. Fentanyl is 50 times more potent than heroin, according to the CDC. As a result, many stories are politically driven or concentrated on criminalization, and few and far between do they offer solutions. The laser focus on fentanyl also neglects other individuals struggling with opioid addiction that could be unrelated to fentanyl and overpowers messages from policy workers.  

“Fortunately, we are seeing a slight trend, increasing in coverage of treatment. But having worked as a journalist, you know, when it bleeds, it leads,” Seckler said. “There is an opportunity here for the media to be able to tell the story better, to be educated more around this, and to think about their responsibility as reporters. How can they help curb this epidemic? How can they ensure that their readers, users, and viewers are all getting the right information that may help them save a life?”

The Society of Professional Journalists states that a principle of ethical journalism is to seek truth, and journalists should avoid stereotypes within that principle. The SPJ also states that ethical journalists should aim to minimize harm and do so by showing compassion for those who might be affected by the news coverage. This is where the careful use of language plays a significant role. Public perception is often synonymous with media coverage and its ability to influence opinion. Action to reduce that stigma can be done simply by educating journalists on how to alter their language and avoid using terminology like “user,” “junkie,” or “addict” in describing someone dealing with substance use disorder.  

“There are a few things that we try to advocate for one is language,” Stoltman said. “We also recommend journalists speak to experts and source their stories with folks trained in addiction treatment, science, and recovery,” he added. “The other big thing is for editors and photographers to select photos and headlines that align. We can do a lot to change the language, but if we choose a headline or a photo that is harmful because the headline is meant to get clicks or the photo is shocking, that does not help folks. We have talked to people with lived experience that say that’s triggering for me.”

Another major problem with adequate coverage of the opioid epidemic is that data is not always timely. It has become apparent that the release of data by the DEA or CDC lags or coincides with political agendas that skew public perception of the severity of opioid use or create unbalanced coverage about fentanyl. This lack of data creates an opportunity for misinformation to thrive and has become a priority for policy workers at Shatterproof to address with the DEA. 

“We see the news stories, but we are also not seeing the news stories. We are seeing republicans talking about fentanyl cartels and soft borders, but that is not really what it is,” said Darryl Phillips, executive director of the non-profit organization, The A$AP Foundation, dedicated to educating young people about substance abuse. “Law enforcement, now that marijuana has been legalized, they do not have the same budget to crack down. It is in everyone’s best interest to rig numbers and not support certain numbers.”

“I watch all sorts of different news,” Stoltman said. “There is certain news that talks a lot about fentanyl but never about solutions, and I can guarantee you do not care about people who are overdosing and dying from these issues. It is just a way of decoded talk about the border, talk about China or talk about Mexico, which isn’t not a problem. But from a research perspective, obviously, that is a big concern.” 

Opioid overdoses and substance abuse disorders threaten our country’s public health, and the media’s role in education is critical but still a work in progress. Though experts have identified how journalists can do better, this new way of thinking and reporting is not expected to change overnight, according to Stoltman. Concerning ethical reporting, the evidence is clear on how these small stylistic changes can yield impactful results. 

“Millions of people in our country are in long-term recovery. Those are people that read your newspapers; they read your stories. Can we be respectful of our whole audience and do it in a way that covers a topic thoughtfully,” Stoltman said. “Because most people come at it thinking about it from a personal failure because that is what they’re used to hearing. The goal is to change the narrative and move it in the right direction. I can say we have seen a big shift in those people that we work with.”