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July 17, 2025 50 mins

This episode explores the "contagious" nature of stigma in substance use disorders (SUDs), revealing how shame and discrimination spread beyond the 45-50 million Americans with SUDs to affect an estimated 45-300 million family members. While stigma's impact on individuals with SUDs is well-documented, this conversation spotlights how families become "stigmatized by association," driving them "underground" and leading to isolation, delayed help-seeking, compromised mental health, strained relationships, and poorer recovery outcomes for the entire family system.

Learning Objectives

  • Identify at least three ways stigma impacts family members of individuals with substance use disorders, including specific effects on mental/physical health, help-seeking behaviors, and family dynamics.
  • Analyze how "stigma by association" creates unique barriers for families in accessing support and contributing to their loved one's change process.
  • Apply evidence-based communication strategies to reduce stigma when interacting with families affected by substance use disorders in professional or community settings.

Host & Guest Bios

  1. Dr. Brandee Madden is an Assistant Professor at Vanderbilt University School of Nursing. She is an experienced nursing educator and psychiatric mental health nurse practitioner who has provided treatment for mental health and substance use disorders in the community for over 15 years. Her clinical expertise is in the treatment of tobacco use in individuals with mental health and substance use disorders.
  2. Dr. Jeff Foote is a psychologist and nationally-recognized clinical researcher with over 30 years of experience in evidence-based treatment for substance use disorders and trauma. He has been driving change in the field of addiction treatment as Co-President and CEO of CMC:Foundation for Change, Co-Founder of the Center for Motivation and Change and co-author of the award-winning books "Beyond Addiction: How Science and Kindness Help People Change" and "The Beyond Addiction Workbook for Family and Friends."
  3. Dr. Carrie Wilkens is a psychologist with over 20 years of experience in substance use, trauma treatment, and working with families of those struggling with substance use. She is the Co-Founder and President of the non-profit, CMC:Foundation for Change, and Co-Founder of the Center for Motivation and Change treatment network and the co-author of the award-winning books "Beyond Addiction: How Science and Kindness Help People Change" and "The Beyond Addiction Workbook for Family and Friends," establishing her as a leader driving change in the field of addiction treatment.

Timestamps:

  • [00:01] – Episode introduction: “Stigmatized by Association” with Dr. Brandi Madden, Dr. Wilkins, and Dr. Foote
  • [03:00] – Three main learning objectives for understanding stigma's impact on families
  • [05:00] – How families are often excluded from treatment systems
  • [07:25] – The double burden: Families are blamed for causing and not fixing the issue
  • [10:45] – The damaging role of labels like “enabler” and “codependent”
  • [16:59] – The turning point: introducing evidence-based co

Find us online at amersa.org, and see our tweets at x.com/AMERSA_tweets.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Learn more about PCSS-MOUD at pcssnow.org.

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